High lifetime probability of screen-detected cervical abnormalities

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http://hdl.handle.net/10138/228479

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Pankakoski , M , Heinavaara , S , Sarkeala , T & Anttila , A 2017 , ' High lifetime probability of screen-detected cervical abnormalities ' , Journal of Medical Screening , vol. 24 , no. 4 , pp. 201-207 . https://doi.org/10.1177/0969141316685740

Title: High lifetime probability of screen-detected cervical abnormalities
Author: Pankakoski, Maiju; Heinavaara, Sirpa; Sarkeala, Tytti; Anttila, Ahti
Contributor: University of Helsinki, Clinicum
Date: 2017-12
Language: eng
Number of pages: 7
Belongs to series: Journal of Medical Screening
ISSN: 0969-1413
URI: http://hdl.handle.net/10138/228479
Abstract: Objective: Regular screening and follow-up is an important key to cervical cancer prevention; however, screening inevitably detects mild or borderline abnormalities that would never progress to a more severe stage. We analysed the cumulative probability and recurrence of cervical abnormalities in the Finnish organized screening programme during a 22-year follow-up. Methods: Screening histories were collected for 364,487 women born between 1950 and 1965. Data consisted of 1 207,017 routine screens and 88,143 follow-up screens between 1991 and 2012. Probabilities of cervical abnormalities by age were estimated using logistic regression and generalized estimating equations methodology. Results: The probability of experiencing any abnormality at least once at ages 30-64 was 34.0% (95% confidence interval [CI]: 33.3-34.6%). Probability was 5.4% (95% CI: 5.0-5.8%) for results warranting referral and 2.2% (95% CI: 2.0-2.4%) for results with histologically confirmed findings. Previous occurrences were associated with an increased risk of detecting new ones, specifically in older women. Conclusion: A considerable proportion of women experience at least one abnormal screening result during their lifetime, and yet very few eventually develop an actual precancerous lesion. Re-evaluation of diagnostic criteria concerning mild abnormalities might improve the balance of harms and benefits of screening. Special monitoring of women with recurrent abnormalities especially at older ages may also be needed.
Subject: Screening
cervical cancer
borderline abnormalities
longitudinal study
HUMAN-PAPILLOMAVIRUS TRIAGE
INTRAEPITHELIAL NEOPLASIA
NATURAL-HISTORY
CANCER
WOMEN
CYTOLOGY
FINLAND
COSTS
PERSISTENCE
PROGRESSION
3142 Public health care science, environmental and occupational health
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