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Screening-preventab...
Screening-preventable cervical cancer risks : evidence from a nationwide audit in Sweden.
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- Andrae, Bengt (författare)
- Karolinska Institutet,Uppsala universitet,Centrum för klinisk forskning, Gävleborg,Department of Obstetrics and Gynecology, Gävle Hospital, Gävle, Sweden
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- Kemetli, Levent (författare)
- Cancer Screening Unit, Oncologic Center M8, Karolinska University Hospital, Stockholm, Sweden
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- Sparén, Pär (författare)
- Karolinska Institutet
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- Silfverdal, Lena, 1955- (författare)
- Umeå universitet,Obstetrik och gynekologi
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- Strander, Björn (författare)
- Oncologic center, Western Region, Sahlgrenska University Hospital, Göteborg, Sweden
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- Ryd, Walter (författare)
- Department of Pathology and Clinical Cytology, Sahlgrenska University Hospital, Göteborg, Sweden
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- Dillner, Joakim (författare)
- Karolinska Institutet,Lund University,Lunds universitet,Klinisk mikrobiologi, Malmö,Forskargrupper vid Lunds universitet,Clinical Microbiology, Malmö,Lund University Research Groups
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- Törnberg, Sven (författare)
- Karolinska Institutet
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(creator_code:org_t)
- Oxford University Press (OUP), 2008
- 2008
- Engelska.
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Ingår i: J Natl Cancer Inst. - : Oxford University Press (OUP). - 1460-2105 .- 0027-8874. ; 100:9, s. 622-9
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http://www.ncbi.nlm....
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https://urn.kb.se/re...
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Ämnesord
Stäng
- Background: The effectiveness of cervical cancer screening programs differs widely in different populations. The reasons for these differences are unclear. Routine and comprehensive audits have been proposed as an ethically required component of screening. We performed a nationwide audit of the effectiveness of the Swedish cervical cancer screening program.Methods: We identified all invasive cervical cancer cases that were diagnosed in Sweden from January 1, 1999, through December 31, 2001, and had been reported to the Swedish Cancer Registry (n = 1230 cases). We verified the diagnoses by histopathologic rereview and matched each case subject to five (population-based) age-matched control subjects who were identified from the National Population Register. The Pap smear screening histories for case and control subjects were reviewed for a 6-year period using the National Cervical Cancer Screening Register, which contains data on essentially all relevant cytological and histological diagnoses in Sweden. Odds ratios (ORs), and their 95% confidence intervals (CIs), of cervical cancer according to screening history were calculated in conditional logistic regression models. All statistical tests were two-sided.Results: Women who had not had a Pap smear within the recommended screening interval had higher risk of cervical cancer than women who had been screened (OR = 2.52, 95% CI = 2.19 to 2.91). This risk was similarly increased for all age groups (Phomogeneity = .96). The risk for nonsquamous cell cervical cancers (OR = 1.59, 95% CI = 1.20 to 2.11) was also increased. Women who had not had a Pap smear within the recommended screening interval had a particularly high risk of advanced cancers (OR = 4.82, 95% CI = 3.61 to 6.44). Among women who had been screened within the recommended interval, those with abnormal Pap smears had a higher risk of cervical cancer than those with normal smears (OR = 7.55, 95% CI = 5.88 to 9.69) and constituted 11.5% of all women with cervical cancer.Conclusions: Nonadherence to screening intervals was the major reason for cervical cancer morbidity. The screening program was equally effective for women of all ages and was also effective against nonsquamous cancers.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Cancer och onkologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cancer and Oncology (hsv//eng)
Nyckelord
- Adenocarcinoma/diagnosis/prevention & control
- Adult
- Carcinoma; Squamous Cell/diagnosis/prevention & control
- Case-Control Studies
- Female
- Humans
- Incidence
- Logistic Models
- Mass Screening/methods/standards
- Medical Audit
- Middle Aged
- Neoplasm Staging
- Odds Ratio
- Primary Prevention/*methods
- Program Evaluation
- Registries
- Risk Assessment
- Risk Factors
- Sweden/epidemiology
- Treatment Refusal
- Uterine Cervical Neoplasms/*diagnosis/epidemiology/pathology/*prevention & control
- Vaginal Smears
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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