Little is known about age-dependent variation in outcomes of cervical cytology with modern technologies. This populationbased study evaluated age-dependent changes after routine implementation of ThinPrep and SurePath technology in two independent laboratories, and controlled for time trends in a third laboratory using manually read conventional cytology continually. Data were collected from the Danish National Health Care Registers. For each laboratory, we compared proportions of abnormal cytology defined as atypical squamous cells of undetermined significance or worse (ASCUS1) by age and technology phase. The study included 489,960 cytological samples with no recent abnormality from women aged 23-59 years, routinely screened between 1998 and 2007. Implementation of SurePath liquid-based cytology (LBC) was followed by an increase in abnormal cytology in women aged 23-29 years from 4.6 to 6.1%, relative proportion (RP): 1.31 [95% confidence interval (CI): 1.08-1.61], and a decrease in women aged 45-59 years from 2.9 to 2.0%, RP: 0.71 (95% CI: 0.60-0.83). Implementation of ThinPrep LBC was followed by a decrease in abnormal cytology both in women aged 23-29 years from 7.7 to 6.8%, RP: 0.89 (95% CI: 0.78-1.02) and in women aged 45-59 years from 3.4 to 1.0%, RP: 0.30 (95% CI: 0.24-0.37). With implementation of imaging-assisted reading, regardless of the brand of technology, the proportion of abnormality increased by around 30% in all age groups (range from 19 to 41%). In the laboratory with unchanged technology no trends in abnormality proportions were observed. The impact of LBC implementation on cytological abnormality proportions varied considerably across age groups.Liquid-based cytology (LBC) and automation-assisted reading of cytological samples have been widely implemented in cervical screening. Little attention has been given in the literature to how cytological abnormality proportions change by age, as a consequence of implementing new cytological technologies. [1][2][3] It is reasonable to test for a potential effect by age, given that infections with human papillomavirus (HPV) and cervical abnormalities are age-dependent.The impact of new cytological technologies on the overall abnormality proportions has been well studied.2,4-8 Important changes in screening efficiency can, though, go unnoticed when the data have not been stratified accordingly. Changes in the abnormality rates in screening are not without an impact on both the women and the health care system.A recent Danish observational study, 9 based on 390,000 cytological samples from the Department of Pathology,
Background:We compared the sensitivity and specificity of liquid-based cytology (LBC) and computer-assisted reading for SurePath/FocalPoint and ThinPrep with those of manually read conventional cytology in routine cervical screening in four Danish laboratories.Methods:Using data from five nationwide registers, technological phases were identified by slide preparation, reading technique, and triage of borderline cytology. Trends in the detection of cervical intraepithelial neoplasia (CIN) were an indicator of the technology's relative sensitivity, and trends in false-positive tests an indicator of relative specificity.Results:At 23–29 years, SurePath/FocalPoint statistically significantly increased the detection of ⩾CIN3 by 85% compared with manually read conventional cytology. The 11% increase with ThinPrep was not significant. At 30–44 years, the increase with SurePath/FocalPoint was 58% the 16% increase with ThinPrep was not significant. At 45–59 years, both technologies led to nonsignificant decreases in the detection. SurePath/FocalPoint doubled the frequency of false-positive tests at any age. With ThinPrep, these proportions remained the same at 23–29 years, but decreased by two-thirds at 45–59 years. In a fourth laboratory with continuous use of manually read conventional cytology, no such trends were seen.Conclusions:The sensitivity and specificity of modern LBC and computer-assisted reading technologies may be brand- and age-dependent.
Objective This study aimed to investigate the effect of a genetic risk score (GRS) comprising 15 single‐nucleotide polymorphisms, previously shown to associate with childhood BMI, on the baseline cardiometabolic traits and the response to a lifestyle intervention in Danish children and adolescents. Methods Children and adolescents with overweight or obesity (n = 920) and a population‐based control sample (n = 698) were recruited. Anthropometric and biochemical measures were obtained at baseline and in a subgroup of children and adolescents with overweight or obesity again after 6 to 24 months of lifestyle intervention (n = 754). The effects of the GRS were examined by multiple linear regressions using additive genetic models. Results At baseline, the GRS associated with BMI standard deviation score (SDS) both in children and adolescents with overweight or obesity (β = 0.033 [SE = 0.01]; P = 0.001) and in the population‐based sample (β = 0.065 [SE = 0.02]; P = 0.001). No associations were observed for cardiometabolic traits. The GRS did not influence changes in BMI SDS or cardiometabolic traits following lifestyle intervention. Conclusions A GRS for childhood BMI was associated with BMI SDS but not with other cardiometabolic traits in Danish children and adolescents. The GRS did not influence treatment response following lifestyle intervention.
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