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Sökning: WFRF:(Dillner J) > Sparen P

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1.
  • Arbyn, M, et al. (författare)
  • Methods for screening and diagnosis
  • 2007
  • Ingår i: 2nd edition of the EU Guidelines for cervical cancer screening. - 9789279076985 ; , s. 69-141
  • Bokkapitel (övrigt vetenskapligt/konstnärligt)
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2.
  • Edvardsson, H., et al. (författare)
  • Nationwide Rereview of Normal Cervical Cytologies before High-Grade Cervical Lesions or before Invasive Cervical Cancer
  • 2021
  • Ingår i: Acta Cytologica. - : S. Karger AG. - 0001-5547 .- 1938-2650. ; 65:5
  • Tidskriftsartikel (refereegranskat)abstract
    • Sweden has experienced an unexpected >30% increase in cervical cancer incidence among women with normal cytological screening results. We therefore performed a nationwide assessment of false-negative cytology before invasive cervical cancer. The Swedish national cervical screening registry identified 2,150 normal cytologies taken up to 10 years before 903 cases of invasive cervical cancer. The 27 cytological laboratories in Sweden were asked to rereview the slides, and all of them completed the rereview. One thousand nine hundred fifteen slides were retrieved and reviewed. Abnormalities were found in 30% of the slides, and the proportion of slides that had a changed diagnosis on rereview increased on average by 3.9% per sampling year during 2001-2016 (p < 0.03). We also asked for rereview of normal smears taken up to 42 months before a histopathologically diagnosed high-grade squamous intraepithelial lesion (HSIL) or adenocarcinoma in situ (AIS). 19/27 laboratories responded, and out of 6,101 normal smears taken before HSIL/AIS, 5,918 were retrieved and rereviewed. The diagnosis was changed in 25% of cases. In summary, we found an increasing time trend of false-negative smears taken before invasive cervical cancer. This indicates a decreased protection of normal cytology in the screening program supporting earlier findings that this is the main reason behind the recent Swedish increase in cervical cancer. We suggest that optimal cervical cancer control may be promoted by routine nationally coordinated rereview of negative smears before high-grade cervical lesions or invasive cervical cancer. © 2021 The Author(s). Published by S. Karger AG, Basel.
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  • Wang, J. R., et al. (författare)
  • Increase of cervical cancer incidence in Sweden in relation to screening history: population cohort study
  • 2020
  • Ingår i: Acta Oncologica. - : Informa UK Limited. - 0284-186X .- 1651-226X. ; 59:8, s. 988-993
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Cervical cancer incidence in Sweden decreased from 24/100,000 in 1965 to 8/100,000 in 2011, but has from 2014 increased to 11/100,000. The increase appears to correlate to screening history. We perform a study of the cancer risk change in relation to screening history over two screening rounds to verify the correlation. Material and methods: We studied the cohorts of all 3,047,850 individual women living in Sweden in each year from 2002-2015. Registry linkages between the Total Population Register, the Swedish National Cervical Screening Registry, the Swedish Cervical Cancer Audit database and the National Quality Register for Gynecological Cancer, defined the incidence rates of invasive cervical cancer comparing time periods 2002-2013 to 2014-2015, in women whose screening history in 2 screening intervals prior to each year were either (i) adequately screened with normal results (almost exclusively cytology, 52% of the population) or (ii) unscreened (13% of the population). We also investigated the incidence increase by time since a normal smear performed in 2002-2012. Results: Among women adequately screened with normal results there was a strong incidence increase in 2014-2015 compared to previous years (Incidence rate ratio (IRR) = 1.59, 95%CI = 1.36-1.85), but no significant increase among unscreened women (IRR = 1.09, 95%CI = 0.94-1.27). There was no increase in incidence 0-2.5 years after a normal smear over the study period (IRR = 1.04, 95% CI = 0.88-1.24), but a strong increase 3-4 years after a normal smear since year 2009 (IRR = 1.52, 95% CI = 1.25-1.84). Conclusion: The results suggest that the overall increase is associated with an increased cancer risk in women adequately screened with normal cytological results. Possibly, precursor lesions missed in one screening round might result in detection of early stage invasive cancer in the subsequent screening.
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6.
  • Carlander, C., et al. (författare)
  • HPV Types in Cervical Precancer by HIV Status and Birth Region: A Population-Based Register Study
  • 2020
  • Ingår i: Cancer Epidemiology Biomarkers & Prevention. - 1055-9965. ; 29:12, s. 2662-2668
  • Tidskriftsartikel (refereegranskat)abstract
    • Background: Data are lacking regarding which human papillomavirus (HPV) types cause high-grade cervical neoplasia (CIN2+) in people with HIV in Europe. We assessed which HPV types are associated with CIN2+ in women living in Sweden by HIV status. Methods: The Swedish National HIV Registry, the Swedish Population Registry, and the Swedish National Cervical Screening Registry were linked. CIN2+ tissue blocks of 130 women living with HIV (WLWH) and 234 HIV-negative women, matched for country of birth (1:2), were retrieved from bio-banks and HPV genotyped. Adjusted ORs (adjOR), stratified by country of birth, were calculated using conditional logistic regression. Matching was broken for cross-group comparisons. Results: WLWH with CIN2 were less likely to have HPV16 [14% vs. 40%; adjOR 0.1; 95% confidence interval (CI), 0.04-0.56] than HIV-negative women, but among women with CIN3, there was no difference in HPV16 prevalence by HIV status (adjOR 0.9; 95% CI, 0.51-1.70). WLWH were six times more likely to have HPV35 in CIN3 than HIV-negative women (adjOR 6.2; 95% CI, 1.3-30.4). WLWH from sub-Saharan Africa (SSA) had less 9-valent vaccine types, compared with both HIV-negative women born in Sweden (adjOR 0.1; 95% CI, 0.02-0.44) and WLWH born in Sweden (adjOR 0.1; 95% CI, 0.01-0.73), mostly because of decreased HPV16 and increased HPV35. Conclusions: WLWH from SSA were less likely to be covered by the 9-valent vaccine, mostly due to less HPV16 and more HPV35. Impact: This could have implications for HPV vaccines, currently not including HPV35, and for HPV-screening algorithms in women with origin from SSA.
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9.
  • Elfstrom, K. M., et al. (författare)
  • Registry-based assessment of the status of cervical screening in Sweden
  • 2016
  • Ingår i: Journal of Medical Screening. - : SAGE Publications. - 0969-1413 .- 1475-5793. ; 23:4, s. 217-226
  • Tidskriftsartikel (refereegranskat)abstract
    • Objectives Comprehensive nationwide monitoring and evaluation of screening through registry-based review of key indicators is necessary for programme optimization, especially as new tests and strategies are introduced. We aimed to investigate and report on the use of these key indicators in the Swedish programme. Setting and methods Organized population-based cervical screening targeting women aged 23-50 and 51-60 every three and five years, respectively, is regionally implemented in Sweden. All cytological and histopathological test results and invitations are exported to the National Cervical Screening Registry. We describe the methods to obtain registry-based quality indicators by age, region, and calendar period. Results In 2013, there were 633,592 cervical smears in Sweden, of which 69% were organized smears resulting from an invitation. Screening test coverage for women aged 23-60 was 80% and similar for the previous decade, but varied greatly between and within counties over-time. Among women aged 23-25, test coverage increased dramatically during the previous six years, reaching 87% in 2013. The proportion of women with cytological high-grade cervical lesions found in cytology that had been followed-up with biopsy within one year was 97%. Major variations in cervical cancer incidence between counties were observed. Conclusions Registry-based analyses of key quality indicators provided the basis for prioritizing improvements of the organized cervical screening programme.
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