Gry St-Martin1, Petra Hall Viborg2, Ane Birgitte Telén Andersen2, Berit Andersen3,4, Jette Christensen5, Dorthe Ejersbo6, Hanne Nørgaard Heje7, Kirsten Marie Jochumsen8, Tonje Johansen9, Lise Grupe Larsen10, Elsebeth Lynge1,11, Reza Rafiolsadat Serizawa12, Marianne Waldstrøm6,13. 1. Center for Epidemiological research, Nykøbing Falster Hospital, Nykøbing Falster, Denmark. 2. The Danish Clinical Registries (RKKP), Frederiksberg/Aarhus N, Denmark. 3. Department of Public Health Programmes, Randers Regional Hospital, Randers, Denmark. 4. Department of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark. 5. Department of Pathology, Aalborg University Hospital, Aalborg, Denmark. 6. Department of Pathology, Vejle, Lillebaelt Hospital, Vejle, Denmark. 7. General Practice, Århus C, Denmark. 8. Department of Gynecology and Obstetrics, Odense University Hospital, Odense C, Denmark. 9. Department of Pathology, Randers Regional Hospital, Randers NØ, Denmark. 10. Department of Pathology, Zealand University Hospital, Naestved, Denmark. 11. Department of Public Health, University of Copenhagen, Copenhagen, Denmark. 12. Department of Pathology, Hvidovre Hospital, Hvidovre, Denmark. 13. Institute of Regional Health Science, University of Southern Denmark, Odense, Denmark.
Abstract
INTRODUCTION: Danish women exit cervical cancer screening at age 65 years, but 23% of cervical cancer cases occur beyond this age. In addition, due to gradual implementation of cervical cancer screening, older women are underscreened by today´s standards. A one-time screening with HPV test was therefore offered to Danish women born before 1948. METHODS: Register based study reporting histology diagnoses and conizations in women found HPV positive in the one-time screening. Number and proportion of women with severe or non-severe histology results were calculated for screened and HPV-positive women by age group or region of residence. Number of women with biopsy and/or conization per case of cervical intraepithelial neoplasia (CIN) grade 2 or worse (CIN2+) or CIN3+ were also calculated by age groups and region. RESULTS: 4,479 (4.1% of screened women) had positive HPV test. 94% of these had one or more additional tests. 2,785 (62%) of HPV-positive women had histology results, and conization was performed in 1,076 (24% of HPV-positive and 1% of all screened women). HPV positivity and CIN3+ detection varied little between regions, but the proportions of HPV positive women undergoing histology varied between regions from 40% to 86% and the proportion with conization from 13% to 36%. Correspondingly, the number of histologies and conizations per CIN3+ detected varied from 5.9 to 11.2 and 1.8 to 4.7, respectively. In total, 514 CIN2+ (0.47% of screened women, 11% of HPV-positive) and 337 CIN3+ (0.31% of screened women, 7.5% of HPV-positive) were diagnosed, including 37 cervical cancer cases. DISCUSSION: HPV screening of insufficiently screened birth cohorts can potentially prevent morbidity and mortality from cervical cancer but longer follow-up is needed to see if cancer incidence declines in the screened women in the coming years. Management strategies differed among regions which influenced the proportions undergoing biopsy/conization.
INTRODUCTION: Danish women exit cervical cancer screening at age 65 years, but 23% of cervical cancer cases occur beyond this age. In addition, due to gradual implementation of cervical cancer screening, older women are underscreened by today´s standards. A one-time screening with HPV test was therefore offered to Danish women born before 1948. METHODS: Register based study reporting histology diagnoses and conizations in women found HPV positive in the one-time screening. Number and proportion of women with severe or non-severe histology results were calculated for screened and HPV-positive women by age group or region of residence. Number of women with biopsy and/or conization per case of cervical intraepithelial neoplasia (CIN) grade 2 or worse (CIN2+) or CIN3+ were also calculated by age groups and region. RESULTS: 4,479 (4.1% of screened women) had positive HPV test. 94% of these had one or more additional tests. 2,785 (62%) of HPV-positive women had histology results, and conization was performed in 1,076 (24% of HPV-positive and 1% of all screened women). HPV positivity and CIN3+ detection varied little between regions, but the proportions of HPV positive women undergoing histology varied between regions from 40% to 86% and the proportion with conization from 13% to 36%. Correspondingly, the number of histologies and conizations per CIN3+ detected varied from 5.9 to 11.2 and 1.8 to 4.7, respectively. In total, 514 CIN2+ (0.47% of screened women, 11% of HPV-positive) and 337 CIN3+ (0.31% of screened women, 7.5% of HPV-positive) were diagnosed, including 37 cervical cancer cases. DISCUSSION: HPV screening of insufficiently screened birth cohorts can potentially prevent morbidity and mortality from cervical cancer but longer follow-up is needed to see if cancer incidence declines in the screened women in the coming years. Management strategies differed among regions which influenced the proportions undergoing biopsy/conization.
Authors: Susanne F Jørgensen; Berit Andersen; Lone Kjeld Petersen; Matejka Rebolj; Sisse H Njor Journal: Cancer Med Date: 2021-11-12 Impact factor: 4.452