Do women ⩾50 years of age need as much screening as women <50 years after they have had negative screening ... View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2008-07-01

AUTHORS

P Armaroli, F Gallo, A Bellomi, S Ciatto, D Consonni, D Davi, P Giorgi-Rossi, A Iossa, E Mancini, C Naldoni, E Polla, G Ronco, M Serafini, V Vergini, L Zanier, M Zappa, N Segnan

ABSTRACT

To assess the adequacy of a routine screening to identify cervical intraepithelial neoplasia 2 or worse (CIN2+) in women over 50 years of age, a retrospective cohort was set in six Italian organised population-based screening programmes. In all, 287 330 women (1 714 550 person-years of observation, 1110 cases) screened at age 25–64, with at least two cytological screening tests, the first negative, were followed from their first negative smear until a biopsy proven CIN2+ lesion or their last negative smear. For women aged 25–49 and 50–64 years, crude and age-standardised detection rate (DR), cumulative risk (CR), adjusted hazard risk for number of previous negative screens, probability of false-positive CIN2+ after two or more smear tests were calculated. Detection rate is significantly lower over 50 years of age. Multivariable analysis shows a significant protective effect from four screening episodes (DR=0.70, 95% CI: 0.51–0.97); the effect of age ⩾50 is 0.29 (95% CI: 0.24–0.35). The CR of CIN2+ is at least eightfold higher in women <50 (CR=2.06, 95% CI: 1.88–2.23) after one previous negative test than in women ⩾50 years with four screens (CR=0.23, 95% CI: 0.00–0.46). Over 50 years of age, after four tests at least three false-positive cases are diagnosed for every true positive. Benefits arising from cytological screening is uncertain in well-screened older women. More... »

PAGES

239-244

Journal

TITLE

British Journal of Cancer

ISSUE

2

VOLUME

99

Author Affiliations

  • SCDO Epidemiologia dei Tumori, Centro Prevenzione Oncologica Regione Piemonte and Azienda Ospedaliero-Universitaria S. Giovanni Battista di Torino, V. San Francesco da Paola 31, 10123, Torino, Italy
  • Servizio di Anatomia Patologica, Ospedale C Poma, Via Al Lago 7, Curtatone, Mantova 46010, Italy
  • Unità di Diagnostica per Immagini, Istituto Scientifico Prevenzione Oncologica, Viale A. Volta 171, 50131, Firenze, Italy
  • Unità Operativa di Epidemiologia, Fondazione IRCCS Ospedale Maggiore Policlinico Mangiagalli e Regina Elena, Via San Barnaba 8, 10122, Milano, Italy
  • Dipartimento di Sanità Pubblica, Azienda Unità Sanitaria Locale di Ferrara, Via F. Beretta 7, 44100, Ferrara, Italy
  • Laziosanità Agenzia di Sanità Pubblica, Regione Lazio, Via Santa Costanza 53, 00198, Roma, Italy
  • Unità Operativa Prevenzione Secondaria Screening-CRR, Istituto Scientifico Prevenzione Oncologica, Viale A. Volta 171, 50131, Firenze, Italy
  • Unità di Valutazione e Organizzazione Screening, Centro Prevenzione Oncologica Regione Piemonte and Azienda Sanitaria Locale TO1, V. San Francesco da Paola 31, 10123, Torino, Italy
  • Assessorato Politiche per la Salute, Regione Emilia-Romagna, Viale A. Moro 21, 40127, Bologna, Italy
  • Istituto di Anatomia Patologica, Ospedale Santa Chiara, Largo Medaglie d’Oro 1, 38100, Trento, Italy
  • Centro di Prevenzione Oncologica, Azienda Unità Sanitaria Locale di Ravenna, Viale Randi 5, 48100, Ravenna, Italy, Italy
  • SCDO Epidemiologia del Tumori, Centro Prevenzione Oncologica Regione Piemonte and Azienda Ospedaliero-Universitaria S. Giovanni Battista di Torino, V. San Francesco da Paola 31, 10123, Torino, Italy
  • Agenzia Regionale di Sanità Friuli Venezia Giulia, Piazzale Santa Maria della Misericordia, 33100, Udine, Italy
  • Unità di Epidemiologia Clinico-descrittiva, Istituto Scientifico Prevenzione Oncologica, Viale A. Volta 171, 50131, Firenze, Italy
  • SCDO Epidemiologia dei Tumori, Centro prevenzione Oncologica Regione Piemonte and Azienda Ospedaliero-Universitaria S. Giovanni Battista di Torino, V. San Francesco da Paola 31, 10123, Torino, Italy
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1038/sj.bjc.6604455

    DOI

    http://dx.doi.org/10.1038/sj.bjc.6604455

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1052803029

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/18594534


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