Screening patterns within organized programs and survival of Italian women with invasive cervical cancer

Zucchetto, Antonella; Ronco, Guglielmo; Rossi, Paolo Giorgi; Zappa, Marco; Ferretti, Stefano; Franzo, Antonella; Falcini, Fabio; Visioli, Carmen Beatriz; Zanetti, Roberto; Biavati, Patrizia; Rosa, Francesco La; Baracco, Susanna; Federico, Massimo; Campari, Cinzia; Togni, Aldo De; Piffer, Silvano; Pannozzo, Fabio; Fusco, Mario; Michiara, Maria; Castaing, Marine; Seghini, Pietro; Tisano, F.; Serraino, Diego

doi:10.1016/j.ypmed.2013.05.018

Cited by 37 publications

(16 citation statements)

References 24 publications

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“…In conclusion, given that 80% of cervical cancer cases among women ≥60 occurred in insufficiently or never‐screened women, and because previous studies report a lower participation rate in screening among women aged 50‐64 compared to younger women, more attention should be given to interventions aimed at increasing the participation rate in screening among women aged 50‐64. An increase in screening participation during the age interval 50‐64 years may likely reduce the cervical cancer incidence in women ≥65.…”

Section: Discussionmentioning

confidence: 96%

Cervical cancer screening history prior to a diagnosis of cervical cancer in Danish women aged 60 years and older—A national cohort study

et al. 2019

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The incidence and mortality of cervical cancer are high in Danish women aged 60 years and older who are about to exit the cervical cancer screening program. The present study aimed to describe the screening history in women ≥60 years old, diagnosed with cervical cancer in Denmark, 2009‐2013. We retrieved information on cases of cervical cancer and previous cervical cancer screening from national registries. During the study period, a total of 1907 women were diagnosed with cervical cancer, 574 (30.1%) of which were ≥60 years old. The majority of women were diagnosed with squamous cell carcinoma (73.7%) and advanced‐stage disease (ASD, ie, ≥FIGO IIB; 63.1%). The proportion of ASD increased with age, from 51.9% in women aged 60‐64% to 76.7% in women aged 75‐79. Among screened women (n = 377), 22.8% had a cervical cytology within 5 years of diagnosis, 73.3% of which were normal, and 45.1% were diagnosed with ASD. Women who had been sufficiently screened prior to screening exit (≥2 normal cytology test in the age interval 50‐59) accounted for 18.1%. Of note, 53.8% of the sufficiently screened women were diagnosed with ASD. Sufficiently screened women were less likely to be diagnosed with ASD compared to never‐screened women (53.8% vs 67.5%, P < 0.020), but no difference was observed between sufficiently and insufficiently screened women (53.8% vs 63.4%, P = 0.091). Our findings suggest that cancer in older women may occur due to insufficient screening prior to screening exit, a low sensitivity of screening, and premature screening exit.

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Section: Discussionmentioning

confidence: 96%

Cervical cancer screening history prior to a diagnosis of cervical cancer in Danish women aged 60 years and older—A national cohort study

et al. 2019

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“…In fact, these genotypes are over-represented in adenocarcinomas and early onset cancers [35][36][37] and are rarely prevented through cytological screening. 2,38,39 It is, however, not clear if for these genotypes the co-existing high risk of developing invasive cancer and low risk of having a pre-cancerous lesion detected depends on a high rate of progression of such lesions to invasion or on the difficulty in detecting them by colposcopy. In any case, these two possible mechanisms result in a too short detectable sojourn time of pre-invasive lesions.…”

Section: Discussionmentioning

confidence: 99%

Human papilloma virus genotyping for the cross‐sectional and longitudinal probability of developing cervical intraepithelial neoplasia grade 2 or more

Mistro

Adcock

Carozzi

et al. 2018

Intl Journal of Cancer

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Human papilloma virus (HPV) testing is more sensitive but less specific than cytology. We evaluated stand‐alone genotyping as a possible triage method. During a multicentre randomised controlled trial comparing HPV testing to conventional cytology, HPV‐positive women were referred to colposcopy and followed up if no high‐grade lesion was detected. HPV‐positive samples were genotyped by GP5+/GP6+ primed polymerase chain reaction followed by reverse line blot. Genotypes were hierarchically ordered by positive predictive value (PPV) for CIN grade 2 or more (CIN2+), and grouped by cluster analysis into three groups (A, B and C in decreasing order). Receiver operating characteristic curves were computed. Among 2,255 HPV‐positive women with genotyping, 239 CIN2+ (including 113 CIN3+) were detected at baseline or during a 3‐year follow‐up. HPV33 had the highest PPV with CIN2+ and CIN3+ as the endpoint and when considering lesions detected at baseline or also during follow‐up. HPV16 and HPV35 were the second and third, respectively. Cross‐sectional sensitivity for CIN2+ at baseline was 67.3% (95% CI 59.7–74.2), 91.8% (95% CI 86.6–95.5) and 94.7% (95% CI 90.2–97.6), respectively, when considering as “positive” any of the HPV types in group A (33, 16 and 35), A or B (31, 52, 18, 59 and 58) and A or B or C (39, 51, 56, 45 and 68). The corresponding cross‐sectional PPVs for CIN2+ were 15.8% 95% (CI 13.2–18.7), 12.0% (95% CI 10.3–13.9) and 9.6% (95% CI 8.2–11.1), respectively. HPV33, 16 and 35 confer a high probability of CIN2+ but this rapidly decreases when adding other genotypes.

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“…Cervical cancer is a major public health problem with approximately 570,000 new cases, and 311,000 deaths globally in 2018, the majority of these in low-and middle-income countries [1]. Even within high income countries, most cervical cancers occur in women who are never or under-screened [2][3][4][5].…”

Section: Introductionmentioning

confidence: 99%

Self-Collection for Cervical Screening Programs: From Research to Reality

Hawkes

Keung

Huang

et al. 2020

Cancers

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In 2018, there were an estimated 570,000 new cases of cervical cancer globally, with most of them occurring in women who either had no access to cervical screening, or had not participated in screening in regions where programs are available. Where programs are in place, a major barrier for women across many cultures has been the requirement to undergo a speculum examination. With the emergence of HPV-based primary screening, the option of self-collection (where the woman takes the sample from the vagina herself) may overcome this barrier, given that such samples when tested using a PCR-based HPV assay have similar sensitivity for the detection of cervical pre-cancers as practitioner-collected cervical specimens. Other advantages of HPV-based screening using self-collection, beyond the increase in acceptability to women, include scalability, efficiency, and high negative predictive value, allowing for long intervals between negative tests. Self-collection will be a key strategy for the successful scale up of cervical screening programs globally in response to the WHO call for all countries to work towards the elimination of cervical cancer as a public health problem. This review will examine self-collection for HPV-based cervical screening including the collection devices, assays and possible routine laboratory processes considering how they can be utilized in cervical screening programs.

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Screening patterns within organized programs and survival of Italian women with invasive cervical cancer

Cited by 37 publications

References 24 publications

Cervical cancer screening history prior to a diagnosis of cervical cancer in Danish women aged 60 years and older—A national cohort study

Cervical cancer screening history prior to a diagnosis of cervical cancer in Danish women aged 60 years and older—A national cohort study

Human papilloma virus genotyping for the cross‐sectional and longitudinal probability of developing cervical intraepithelial neoplasia grade 2 or more

Self-Collection for Cervical Screening Programs: From Research to Reality

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