Effectiveness of Cervical Testing in and outside a Screening Program—A Case-Control Study

Pankakoski, Maiju; Sarkeala, Tytti; Anttila, Ahti; Heinävaara, Sirpa

doi:10.3390/cancers14215193

Cited by 3 publications

(1 citation statement)

References 43 publications

(59 reference statements)

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“…The screening invitations covered 95%–100% of the target population during the whole study period ( 16 ). Data on tests outside the program were gathered from pathology laboratories, the nationwide Health Insurance Reimbursement Register (Kela), and the Finnish Student Health Services ( 19 ). All major laboratories operating at the time of the study delivered us data, except for a few small laboratories in the northwest part of the country.…”

Section: Methodsmentioning

confidence: 99%

Effect of Test History at Ages 50–64 on Later Cervical Cancer Risk: A Population-based Case–control Study

Kultalahti,

Heinävaara,

Sarkeala

et al. 2023

Cancer Research Communications

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As life expectancy increases, the effectiveness of cervical cancer screening programs needs to be reassessed for the older population. We addressed the effect of test history in and outside organized screening at age 50–64 years on later cervical cancer risk. A case-control study was conducted by deriving 229 cases of 65–79-year-old women with invasive cervical cancer in 2010–2019 from the Finnish Cancer Registry. Ten controls were matched for each case by birth year and hospital district. The effect of test uptake and abnormal results in 50–64-year-olds on cancer risk was investigated using conditional logistic regression and adjusted for self-selection. Test uptake within the 50–64-year age-group showed 75% lower odds of cervical cancer (adjusted odds ratio [aOR] = 0.25; 95% confidence interval [95% CI], 0.18–0.35). Untested women had 4.9 times higher odds than those tested with normal results (aOR = 4.86; 95% CI, 3.42–6.92). Having at least one abnormal test result increased the odds by 2.5 when compared to only normal results but showed lower odds when compared to untested women. The importance of testing is exhibited by the result showing a reduction of odds of cancer to one-fourth for those tested compared to untested. Similarly, receiving abnormal results was protective of cancer compared to having no tests highlighting the importance of proper follow-up. Therefore, screening history should be considered when further developing cervical cancer screening programs with special interest in non-attenders and those receiving abnormal results at older ages.

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Section: Methodsmentioning

confidence: 99%

Effect of Test History at Ages 50–64 on Later Cervical Cancer Risk: A Population-based Case–control Study

Kultalahti,

Heinävaara,

Sarkeala

et al. 2023

Cancer Research Communications

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Similar effectiveness with primary HPV and cytology screening - Long-term follow-up of randomized cervical cancer screening trial

Vahteristo,

Leinonen,

Sarkeala

et al. 2024

Gynecologic Oncology

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Global, regional, and national quality of care index of cervical and ovarian cancer: a systematic analysis for the global burden of disease study 1990–2019

Azangou-Khyavy,

Ghasemi,

Rezaei

et al. 2024

BMC Women's Health

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Background and objective Cervical cancer is the most preventable and ovarian cancer is the most lethal gynecological cancer. However, in the world, there are disparities in health care performances resulting in differences in the burden of these cancers. The objective of this study was to compare the health-system quality of care and inequities for these cancers using the Quality of Care Index (QCI). Material and methods The 1990–2019 data of the Global Burden of Disease (GBD) was analyzed to extract rates of incidence, prevalence, mortality, Disability-Adjusted Life Years (DALYs), Years of Life Lost (YLL), and Years of healthy life lost due to disability (YLD) of cervical and ovarian cancer. Four indices were developed as a proxy for the quality of care using the above-mentioned rates. Thereafter, a Principal Components Analysis (PCA) was applied to construct the Quality of Care Index (QCI) as a summary measure of the developed indices. Results The incidence of cervical cancer decreased from 1990 to 2019, whereas the incidence of ovarian cancer increased between these years. However, the mortality rate of both cancers decreased in this interval. The global age-standardized QCI for cervical cancer and ovarian cancer were 43.1 and 48.5 in 1990 and increased to 58.5 and 58.4 in 2019, respectively. QCI for cervical cancer and ovarian cancer generally decreased with aging, and different age groups had inequitable QCIs. Higher-income countries generally had higher QCIs for both cancers, but exceptions were also observed. Conclusions Uncovering disparities in cervical and ovarian cancer care across locations, Socio-Demographic Index levels, and age groups necessitate urgent improvements in healthcare systems for equitable care. These findings underscore the need for targeted interventions and prompt future research to explore root causes and effective strategies for narrowing these gaps.

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Effectiveness of Cervical Testing in and outside a Screening Program—A Case-Control Study

Cited by 3 publications

References 43 publications

Effect of Test History at Ages 50–64 on Later Cervical Cancer Risk: A Population-based Case–control Study

Effect of Test History at Ages 50–64 on Later Cervical Cancer Risk: A Population-based Case–control Study

Similar effectiveness with primary HPV and cytology screening - Long-term follow-up of randomized cervical cancer screening trial

Global, regional, and national quality of care index of cervical and ovarian cancer: a systematic analysis for the global burden of disease study 1990–2019

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