Cervical dysplasia in elderly women performing repeated self-sampling for HPV testing

Lindström, Annika K.,1953-Uppsala universitet,Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden; Center for Clinical Research, Dalarna, Uppsala University, Uppsala, Sweden,Centrum för klinisk forskning Dalarna,Institutionen för kvinnors och barns hälsa,Örebro Univ, Clin Res Ctr, Fac Med & Hlth, Örebro, Sweden (author)

Funding Agency:Uppsala-Örebro Regional Research Council RFR - 383351 RFR - 561251
BACKGROUND: About 30% of the cervical cancer cases in Sweden occur in women older than 60. The primary aim was to evaluate the acceptability of repeated self-sampling at home for HPV-testing in elderly women. The prevalence of HPV and HPV related dysplasia as well as the sensitivity of cytology was evaluated.METHODS: Repeated self-sampling at home for HPV testing was offered 375 women in each of the four age groups 60, 65, 70 and 75 years. Women with two consecutive positive HPV tests were examined with sampling for histology and cytology.FINDINGS: A self-sample was provided by 59.5% (893/1500) of the invited women. The overall prevalence of HPV was 4.4% (95% CI 3.2-6.0, n = 39) in the first test, and 2.5% were persistent positive in the second test (95% C 1.6-3.8, n = 22) collected on average 5.5 months later. Dysplasia, was found in 1.8% (16/893) (95% CI 1.1-3.0) and CIN 2+ in 1.0% (9/893) (95%CI 0.5-2.0) of the women. Of the 16 women with dysplasia in histology, 13 (81.2%) had a normal cytology.INTERPRETATION: Repeated self-sampling at home combined with HPV testing was well accepted among elderly women. A high prevalence of CIN was diagnosed by histology. Cytology showed extremely low sensitivity and should not be recommended for this age group.

Sanchez Hermansson, RuthUppsala universitet,Reproduktionsbiologi,Örebro Univ, Fac Med & Hlth, Dept Oncol, Örebro, Sweden(Swepub:uu)ruthe270 (author)
Gustavsson, Inger M.Uppsala universitet,Medicinsk genetik och genomik(Swepub:uu)ingergus (author)
Lindberg, Julia HedlundUppsala universitet,Medicinsk genetik och genomik(Swepub:uu)julin226 (author)
Gyllensten, Ulf B.Uppsala universitet,Medicinsk genetik och genomik(Swepub:uu)ulfgyll (author)
Olovsson, Matts,1958-Uppsala universitet,Reproduktionsbiologi(Swepub:uu)mattolov (author)
Örebro universitetInstitutionen för medicinska vetenskaper (creator_code:org_t)

By the author/editor: Lindström, Annik ...; Sanchez Hermanss ...; Gustavsson, Inge ...; Lindberg, Julia ...; Gyllensten, Ulf ...; Olovsson, Matts, ...

About the subject

MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Cancer and Oncol ...

MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Obstetrics Gynae ...

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