Human Papillomavirus Testing in the Last Cervical Screening Round at Age 60–64 Years

Schroll, Jeppe Bennekou; Serizawa, Reza

doi:10.1097/aog.0000000000004522

Cited by 3 publications

(3 citation statements)

References 20 publications

(29 reference statements)

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“…We suspect HPV infection rates to be much higher and a potential target for testing in this age group. In 1 study, it was demonstrated that including HPV testing led to a more than 50% detection of high-grade CIN lesions compared with testing with cytology alone, especially in the elderly 21 . Extending HPV screening beyond age 65 as a primary screening method may therefore be beneficial.…”

Section: Discussionmentioning

confidence: 99%

Opportunities Missed: Cervix Cancer Screening Failures in Women Aged 65 and Older

Ing

Scott

Lentz

2023

J Low Genit Tract Dis

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Objectives This study aimed to determine the screening history and associated outcomes of women diagnosed with cervical cancer after age 65. Methods All patients from 2012 to 2021 diagnosed with squamous, adenocarcinoma, neuroendocrine, or adenosquamous cervical cancer after age 65 in a single managed care organization (MCO) were included in this retrospective cohort study. Demographic, medical, screening, pathologic, follow-up, and treatment data were extracted. Statistical analysis was done using chi-square test and logistic regression. Cancer-specific survival was estimated using the Kaplan-Meier method. Results Of 2,175 patients screened, 209 met inclusion criteria. Only 26.3% of patients had appropriate cervical cancer screening and 41% of patients died of their disease. Managed care organization membership duration of more than 5 years positively correlated with proper cervical cancer screening (p < .001); however, 64% of the long-term members still did not meet criteria to end screening at age 65, with 42.6% of these patients having more than 25 physician visit opportunities to address screening. Increased physician visits correlated with earlier stage at diagnosis of cervical cancer (p = .012). Median cancer-specific survival was significantly better in properly screened patients at 68 vs 30 months, respectively (p = .03). Conclusions Most patients diagnosed with cervical cancer after age 65 did not have adequate previous screening, including those who were MCO members for more than 5 years. There were many missed opportunities for screening, despite multiple provider touchpoints. Our data suggest that adequate screening confers a survival benefit secondary to earlier stage at diagnosis. Further study in this age group is needed to redefine the criteria to end cervix cancer screening.

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Section: Discussionmentioning

confidence: 99%

Opportunities Missed: Cervix Cancer Screening Failures in Women Aged 65 and Older

Ing

Scott

Lentz

2023

J Low Genit Tract Dis

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“…There is an error in Figure 1 in the article by McAdams and Lakshminrusimha in the January 2022 issue. 1 The abbreviation for "American College of Nurse Midwives" is incorrectly listed in the figure as "ANCM." The correct abbreviation is "ACNM.…”

Section: Management Of Placental Transfusion To Neonates After Delive...mentioning

confidence: 99%

mentioning

confidence: 99%

Human Papillomavirus Testing in the Last Cervical Screening Round at Age 60–64 Years: Correction

2022

Obstetrics &Amp; Gynecology

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Cervical cancer incidence in Denmark: Disentangling determinants of time trend

Lynge,

Bennekou Schroll,

Andersen

et al. 2024

Intl Journal of Cancer

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Cervical cancer is a preventable disease. Nevertheless, stagnation has been seen in incidence rates also in countries with well‐functioning healthcare. On this basis, we investigated associations between control interventions and changes in cervical cancer incidence in Denmark from 2009 to 2022. Data on human papillomavirus (HPV)‐vaccination were retrieved from Staten's Serum Institute; on screening recommendations from Danish Health Authority, on screening performance from Danish Quality Database for Cervical Screening; and on cervical cancer incidence from Nordcan and Danish Cancer Register. We reported coverage with HPV vaccination (1+ dose); coverage with cervical cell samples; number of women with primary HPV tests; proportion of non‐normal cell samples without timely follow‐up; number of conizations; and cervical cancer incidence rates. In 2022, all women aged ≤29 had been offered childhood HPV vaccination with coverage of 80%–90%. By 2020–2022, the cervical cancer incidence rate in women aged 20–29 was 3 per 100,000; at level of disease elimination. In 2017, women aged 70+ were offered a one‐time HPV screening, and by 2020–2022, the old‐age peak in cervical cancer incidence had largely disappeared. From 2009 to 2022, proportion of non‐normal cell samples without timely follow‐up decreased from 20% to 10%, and conventional cytology was largely replaced by SurePath liquid‐based cytology; these factors could explain the steady decrease in cervical cancer incidence rate. Implementation of primary HPV screening in women aged 30–59 in 2021 was reflected in a, probably temporary, increase in the 2022 cervical cancer incidence rate. In conclusion, combined interventions with childhood HPV vaccination; one‐time HPV screening of elderly women; and better management of screening broke previous stagnation in cervical cancer incidence rate.

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Human Papillomavirus Testing in the Last Cervical Screening Round at Age 60–64 Years

Abstract: Cervical human papillomavirus testing led to more positive screening test results and diagnoses of high-grade cervical intraepithelial lesions than cytology.

Cited by 3 publications

References 20 publications

Opportunities Missed: Cervix Cancer Screening Failures in Women Aged 65 and Older

Opportunities Missed: Cervix Cancer Screening Failures in Women Aged 65 and Older

Human Papillomavirus Testing in the Last Cervical Screening Round at Age 60–64 Years: Correction

Cervical cancer incidence in Denmark: Disentangling determinants of time trend

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