Large performance variation does not affect outcome in the Finnish cervical cancer screening programme

Lönnberg, Stefan; Nieminen, Pekka; Kotaniemi-Talonen, Laura; Kujari, Harry; Melkko, Jukka; Granroth, Gustav; Vornanen, Martine; Pietiläinen, Timo; Arola, Johanna; Tarkkanen, Jussi; Luostarinen, Tapio; Anttila, Ahti

doi:10.1111/j.1365-2303.2011.00849.x

Cited by 7 publications

(5 citation statements)

References 19 publications

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“…The increased mortality was related to every cause-of-death category, i.e., malignant neoplasm; dementia; diseases of circulatory, respiratory, and digestive systems; and other. Our study area lies in the western coast of Finland; there are regional differences of mortality in favor of Western Finland compared to Eastern Finland [12]. This aspect enhances the mortality difference between the hip fracture patients and the general population of our study.…”

Section: Discussionmentioning

confidence: 99%

Mortality and cause of death in hip fracture patients aged 65 or older - a population-based study

Panula¹,

Pihlajamäki

Mattila

et al. 2011

BMC Musculoskelet Disord

468

307

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BackgroundThe high mortality of hip fracture patients is well documented, but sex- and cause-specific mortality after hip fracture has not been extensively studied. The purpose of the present study was to evaluate mortality and cause of death in patients after hip fracture surgery and to compare their mortality and cause of death to those in the general population.MethodsRecords of 428 consecutive hip fracture patients were collected on a population-basis and data on the general population comprising all Finns 65 years of age or older were collected on a cohort-basis. Cause of death was classified as follows: malignant neoplasms, dementia, circulatory disease, respiratory disease, digestive system disease, and other.ResultsMean follow-up was 3.7 years (range 0-9 years). Overall 1-year postoperative mortality was 27.3% and mortality after hip fracture at the end of the follow-up was 79.0%. During the follow-up, age-adjusted mortality after hip fracture surgery was higher in men than in women with hazard ratio (HR) 1.55 and 95% confidence interval (95% CI) 1.21-2.00. Among hip surgery patients, the most common causes of death were circulatory diseases, followed by dementia and Alzheimer's disease. After hip fracture, men were more likely than women to die from respiratory disease, malignant neoplasm, and circulatory disease. During the follow-up, all-cause age- and sex-standardized mortality after hip fracture was 3-fold higher than that of the general population and included every cause-of-death category.ConclusionDuring the study period, the risk of mortality in hip fracture patients was 3-fold higher than that in the general population and included every major cause of death.

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Section: Discussionmentioning

confidence: 99%

Mortality and cause of death in hip fracture patients aged 65 or older - a population-based study

Panula¹,

Pihlajamäki

Mattila

et al. 2011

BMC Musculoskelet Disord

468

307

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“…When HPV Stand-alone is compared with the Cytology Algorithm, the HPV test finds radically more CIN II+ cases than the cytological test. However, the Finnish primary cytology screening has been of a high impact and has had a low probability of such false negative cytological diagnoses that would have led to cervical cancer diagnosed after the screening visits [29,30]. This may be of relevance also considering that all the HPV algorithms with cytology triage, except for Decisive Cytology Algorithm 1, would lead to a higher overall CIN II+ detection probability than the Cytology Algorithm.…”

Section: Discussionmentioning

confidence: 99%

Alternative cytology triage strategies for primary HPV screening

Vahteristo

Heinävaara²,

Anttila³

et al. 2022

Gynecologic Oncology

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“…It has been reported that large variation existed between cytopathology laboratories in the rates of follow-up recommendations and referrals, although this was not shown to have an impact on the effectiveness of screening. 26 According to national guidelines, borderline results should always be followed up with an intensified frequency. We reported that only 73% of the borderline results led to recommendation for follow-up screening, suggesting that not all municipalities followed the guidelines.…”

Section: Discussionmentioning

confidence: 99%

High lifetime probability of screen-detected cervical abnormalities

et al. 2017

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ObjectiveRegular 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.MethodsScreening 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.ResultsThe 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.ConclusionA 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.

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Large performance variation does not affect outcome in the Finnish cervical cancer screening programme

Cited by 7 publications

References 19 publications

Mortality and cause of death in hip fracture patients aged 65 or older - a population-based study

Mortality and cause of death in hip fracture patients aged 65 or older - a population-based study

Alternative cytology triage strategies for primary HPV screening

High lifetime probability of screen-detected cervical abnormalities

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