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- Strander, Björn, 1952, et al.
(author)
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Does HPV-status 6-12 months after treatment of high grade dysplasia in the uterine cervix predict long term recurrence?
- 2007
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In: Eur J Cancer. ; 43:12, s. 1849-55
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Journal article (peer-reviewed)abstract
- BACKGROUND: Women once treated for high grade cervical dysplasia have a high long term risk for developing new dysplasia or cancer. OBJECTIVES: To investigate if human papilloma virus (HPV)-negativity after treatment of cervical dysplasia reduces the need for frequent long term follow up. DESIGN: Case/control study based on archival smears. METHODS: Women with cervical intraepithelial neoplasi (CIN)2-3, treated for dysplasia and with recurrence of CIN2+ more than 2 years after treatment were compared with controls without recurrence, matched for age and date of treatment. High risk-HPV-DNA were analysed with PCR from two archival smears per woman. Mean follow up time was 14.6 years. RESULTS: 24% (45/189) of cases and 11% (43/378) of controls were HPV-positive in any of two smears. Odds ratio (OR)=2.5 (1.6-3.8). CONCLUSION: HPV-status 6-12 months after treatment of high grade dysplasia is of limited value for the design of long term follow up.
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- Wiik, J., et al.
(author)
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Cervical excisional treatment, HPV infection and risk of preterm delivery - a Swedish population-based study
- 2020
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In: Geburtshilfe und Frauenheilkunde. - : © 2020. Thieme. All rights reserved.. - 1438-8804 .- 0016-5751. ; 80:10
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Journal article (peer-reviewed)abstract
- Objective Excisional treatment for cervical intraepithelial neoplasia (CIN) is associated with preterm delivery (PTD). It has been shown that even untreated CIN is associated with PTD. We aimed to explore the magnitude of the associations of CIN with PTD and adverse obstetrical outcome. Methods Retrospective register-based study comprising all women with singleton deliveries in Sweden 1999-2016. Data were retrieved from the Medical Birth Registry and the Swedish National Cervical Screening Registry. Women with normal cytology all life (n = 340,290) were compared to a) women with sign of HPV-infection close to pregnancy (abnormal cytology (n = 11,936) or positive HPV-test (n = 2,587)), b) women treated for CIN before delivery (n = 25,123) and c) women with CIN/carcinoma diagnosed after delivery (n = 34,251) by logistic regression adjusted for socioeconomic and health-related confounders. Results PTD was increased in all groups compared to women with normal cytology all life (4.7 %), with greatest risk for the treated group (9,0 %, OR 1.80 (1.71-1.89)), but also for women with HPV-infection close to pregnancy (5,9 %, OR 1.19 (1.10-1.29)) and CIN/carcinoma after delivery (6,1 %, OR 1.10 (1.04-1.16)). Paired analysis in 5,547 women with deliveries both before and after treatment showed increased risk of PTD after treatment (OR 1.27 (1.07-1.50)). The treated group had increased risk also for preterm prelabour rupture of the membranes (pPROM, OR 2.25 (2.08-2.44)) and chorioamnionitis (2.44 (2.05-2.90)). HPV-infection close to pregnancy was associated with pPROM (OR 1.22 (1.06-1.40)). Conclusions Women with HPV infection close to pregnancy have a small increased risk for PTD and pPROM while excisional treatment increases risks further.
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- Bistoletti, P, et al.
(author)
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Screening for cervixcancer kan vara kostnadseffektiv. Kombinationen cellprov och HPV-test skulle ge ytterligare vinster.
- 2005
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In: Läkartidningen. - 0023-7205. ; 102:24-25, s. 1874-1879
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Journal article (peer-reviewed)abstract
- En hälsoekonomisk utvärdering av cellprovsscreening för cervixcancer har saknats vad gäller svenska förhållanden. I en modellstudie jämfördes effekter av och kostnader för gynekologisk cellprovskontroll med och utan tillägg av test för humant papillomvirus (HPV). Med cellprovsscreening i åldern 32–60 år vart tredje till vart femte år minskar risken att insjukna i invasiv cervixcancer med 88 procent, och sjukvårdens kostnader halveras jämfört med att inte screena. Med tillägg av ett eller två HPV-test vid 32 års ålder och oförändrad screeningpolicy ökar kostnaderna, och inga hälsovinster kan påvisas. En screeningstrategi med cellprov i kombination med HPV-test vid enbart tre tillfällen i livet – vid 32, 41 och 50 års ålder – kostar mindre och ger, enligt modellen, hälsovinster jämfört med enbart cellprovsscreening i åldern 32–60 år.
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- Edvardsson, H., et al.
(author)
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Nationwide Rereview of Normal Cervical Cytologies before High-Grade Cervical Lesions or before Invasive Cervical Cancer
- 2021
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In: Acta Cytologica. - : S. Karger AG. - 0001-5547 .- 1938-2650. ; 65:5, s. 377-384
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Journal article (peer-reviewed)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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