| 1. |
- Dillner, Lena, et al.
(författare)
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Randomized healthservices study of human papillomavirus-based management of low-grade cytological abnormalities.
- 2011
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Ingår i: International Journal of Cancer. - : Wiley. - 0020-7136 .- 1097-0215. ; okt, s. 151-159
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Tidskriftsartikel (refereegranskat)abstract
- Human Papillomavirus (HPV)-based management of women with borderline (ASCUS) or mildly abnormal (CINI) cervical cytology has been extensively studied in the research setting. We wished to assess safety and healthcare resource use of a real-life healthcare policy using HPV triaging.All 15 outpatient clinics involved in the organized population-based screening program in Stockholm, Sweden screening program were randomized to either continue with prior policy (colposcopy of all women with ASCUS/CINI) or to implement a policy with HPV triaging and colposcopy only of HPV-positive women. The trial enrolled the 3319 women that were diagnosed with ASCUS (n=1335) or CINI (n=1984) in Stockholm during 17(th) March 2003 to 16(th) January 2006. Detection of high-grade cervical lesions (CINII+) and health care cost consumption was studied by registry linkages.The proportion of histopathology-verified CINII+ was similar for the 2 policies (395/1752 women (22.5%; 95% Confidence interval (CI): 20,6-24,6%) had CINII+ diagnosed with HPV triaging policy, 318/1567 women (20.3%; 95%CI: 18,3-22,4%)) had CINII+ with colposcopy policy). 64% of women with ASCUS and 77% of women with CINI were HPV-positive. HPV-positivity was age-dependent, with 81% of women below 35 years of age and 44% of women above 45 years of age testing HPV-positive. HPV triaging was cost-effective only above 35 years of age.In conclusion, a real-life randomised healthservices study of HPV triaging of women with ASCUS/CINI demonstrated similar detection of CINII+ as colposcopy of all women.
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| 2. |
- Andersson, Hans, et al.
(författare)
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Järn och städer : Tankar kring det arkeologiska materialet i Bergen och Gamla Lödöse
- 2015
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Ingår i: Järnet och Sveriges medeltida modernisering. - 0347-4283. - 9789197778374 ; 48, s. 215-249
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Bokkapitel (refereegranskat)abstract
- Slutrapport för projektet Järnet och riksbildningen 1150-1350 (Jernkontort). I uppsatsen diskuteras konsumtion av järn i Bergen och Lödöse baserad på arkeologiskt material. Med utgångspunkt från resultaten görs bl a försök att hypotetiskt bestämma omfattningen av järn totalt i de äldre medeltida städerna i Sverige.
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| 3. |
- Dahlström, Lisen Arnheim, et al.
(författare)
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Prospective study of human papillomavirus and risk of cervical adenocarcinoma.
- 2010
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Ingår i: International journal of cancer. Journal international du cancer. - : Wiley. - 1097-0215 .- 0020-7136. ; 127:8, s. 1923-30
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Tidskriftsartikel (refereegranskat)abstract
- Human papillomaviruses (HPV) are established as a major cause of cervical carcinoma. However, causality inference is dependent on prospective evidence showing that exposure predicts risk for future disease. Such evidence is available for squamous cell carcinoma, but not for cervical adenocarcinoma. We followed a population-based cohort of 994,120 women who participated in cytological screening in Sweden for a median of 6.7 years. Baseline smears from women who developed adenocarcinoma during follow-up (118 women with in situ disease and 164 with invasive disease) and their individually matched controls (1,434 smears) were analyzed for HPV using PCR. Conditional logistic regression was used to estimate odds ratios (OR) of future adenocarcinoma with 95% confidence intervals (CI). Being positive for HPV 16 in the first cytologically normal smear was associated with increased risks for both future adenocarcinoma in situ (OR: 11.0, 95% CI: 2.6-46.8) and invasive adenocarcinoma (OR: 16.0, 95% CI: 3.8-66.7), compared to being negative for HPV 16. Similarly, an HPV 18 positive smear was associated with increased risks for adenocarcinoma in situ (OR: 26.0, 95% CI: 3.5-192) and invasive adenocarcinoma (OR: 28.0, 95% CI: 3.8-206), compared to an HPV 18 negative smear. Being positive for HPV 16/18 in 2 subsequent smears was associated with an infinite risk of both in situ and invasive adenocarcinoma. In conclusion, infections with HPV 16 and 18 are detectable up to at least 14 years before diagnosis of cervical adenocarcinoma. Our data provide prospective evidence that the association of HPV 16/18 with cervical adenocarcinoma is strong and causal.
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