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Cervical cancer mortality in Norway according to screening attendance and age

INTRODUCTION: The association between cervical cancer screening and reduction of cervical cancer has been dealt with in much research. However, little has been published on the association between screening and cervical cancer mortality. We assessed cervical cancer deaths according to screening hist...

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Autores principales: Baasland, Ingrid, Vie, Gunnhild Å., Romundstad, Pål R., Lönnberg, Stefan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9564434/
https://www.ncbi.nlm.nih.gov/pubmed/35689441
http://dx.doi.org/10.1111/aogs.14402
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author Baasland, Ingrid
Vie, Gunnhild Å.
Romundstad, Pål R.
Lönnberg, Stefan
author_facet Baasland, Ingrid
Vie, Gunnhild Å.
Romundstad, Pål R.
Lönnberg, Stefan
author_sort Baasland, Ingrid
collection PubMed
description INTRODUCTION: The association between cervical cancer screening and reduction of cervical cancer has been dealt with in much research. However, little has been published on the association between screening and cervical cancer mortality. We assessed cervical cancer deaths according to screening history, histopathology, and age among women in, under, and above screening age. MATERIAL AND METHODS: In this nationwide, registry‐based case–control study from Norway, we included 817 cervical cancer deaths in women diagnosed with cervical cancer in the period 1998–2009. We matched each case with 10 population‐based controls free from cervical cancer, obtained by density‐based sampling. Odds ratios (ORs) with 95% confidence intervals (CIs) for the association between screening attendance and cervical cancer mortality were estimated using conditional logistic regression models. RESULTS: Of all fatal cervical cancers, 35% were diagnosed among women over screening age and altogether, 83% were either in age groups not covered by the screening program or in non‐attenders of screening age. The estimated risk reduction associated with a cytology test in the preceding 3.5 years was 80% in screening age 25–69 years (OR 0.20; 95% CI 0.16–0.24) with the largest reduction in squamous cell carcinomas (84%) but also a substantial estimated risk reduction of 65% for adenocarcinomas. The associated risk reduction was strongest in women aged 45–69 years, with ORs in the range 0.09–0.18, compared with ORs 0.42–1.35 in women aged 25–39 years. CONCLUSIONS: To reduce the mortality of cervical cancer, screening programs should focus on increasing adherence to the program, as half of all the fatal cases were in the non‐attender group. Further assessments regarding the potential preventive impact of extending screening to women over the current screening age should be considered.
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spelling pubmed-95644342022-12-06 Cervical cancer mortality in Norway according to screening attendance and age Baasland, Ingrid Vie, Gunnhild Å. Romundstad, Pål R. Lönnberg, Stefan Acta Obstet Gynecol Scand Epidemiology INTRODUCTION: The association between cervical cancer screening and reduction of cervical cancer has been dealt with in much research. However, little has been published on the association between screening and cervical cancer mortality. We assessed cervical cancer deaths according to screening history, histopathology, and age among women in, under, and above screening age. MATERIAL AND METHODS: In this nationwide, registry‐based case–control study from Norway, we included 817 cervical cancer deaths in women diagnosed with cervical cancer in the period 1998–2009. We matched each case with 10 population‐based controls free from cervical cancer, obtained by density‐based sampling. Odds ratios (ORs) with 95% confidence intervals (CIs) for the association between screening attendance and cervical cancer mortality were estimated using conditional logistic regression models. RESULTS: Of all fatal cervical cancers, 35% were diagnosed among women over screening age and altogether, 83% were either in age groups not covered by the screening program or in non‐attenders of screening age. The estimated risk reduction associated with a cytology test in the preceding 3.5 years was 80% in screening age 25–69 years (OR 0.20; 95% CI 0.16–0.24) with the largest reduction in squamous cell carcinomas (84%) but also a substantial estimated risk reduction of 65% for adenocarcinomas. The associated risk reduction was strongest in women aged 45–69 years, with ORs in the range 0.09–0.18, compared with ORs 0.42–1.35 in women aged 25–39 years. CONCLUSIONS: To reduce the mortality of cervical cancer, screening programs should focus on increasing adherence to the program, as half of all the fatal cases were in the non‐attender group. Further assessments regarding the potential preventive impact of extending screening to women over the current screening age should be considered. John Wiley and Sons Inc. 2022-06-11 /pmc/articles/PMC9564434/ /pubmed/35689441 http://dx.doi.org/10.1111/aogs.14402 Text en © 2022 The Authors. Acta Obstetricia et Gynecologica Scandinavica published by John Wiley & Sons Ltd on behalf of Nordic Federation of Societies of Obstetrics and Gynecology (NFOG). https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Epidemiology
Baasland, Ingrid
Vie, Gunnhild Å.
Romundstad, Pål R.
Lönnberg, Stefan
Cervical cancer mortality in Norway according to screening attendance and age
title Cervical cancer mortality in Norway according to screening attendance and age
title_full Cervical cancer mortality in Norway according to screening attendance and age
title_fullStr Cervical cancer mortality in Norway according to screening attendance and age
title_full_unstemmed Cervical cancer mortality in Norway according to screening attendance and age
title_short Cervical cancer mortality in Norway according to screening attendance and age
title_sort cervical cancer mortality in norway according to screening attendance and age
topic Epidemiology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9564434/
https://www.ncbi.nlm.nih.gov/pubmed/35689441
http://dx.doi.org/10.1111/aogs.14402
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AT lonnbergstefan cervicalcancermortalityinnorwayaccordingtoscreeningattendanceandage