High-grade cervical intraepithelial neoplasia in human papillomavirus self-sampling of screening non-attenders
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High-grade cervical intraepithelial neoplasia in human papillomavirus self-sampling of screening non-attenders. / Lam, J.U.H.; Elfström, K M; Ejegod, D. M.; Pedersen, H.; Rygaard, C.; Rebolj, M.; Lynge, E; Juul, K. E.; Kjær, S. K.; Dillner, J.; Bonde, J.
I: B J C, Bind 118, 2018, s. 138–144 .Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - High-grade cervical intraepithelial neoplasia in human papillomavirus self-sampling of screening non-attenders
AU - Lam, J.U.H.
AU - Elfström, K M
AU - Ejegod, D. M.
AU - Pedersen, H.
AU - Rygaard, C.
AU - Rebolj, M.
AU - Lynge, E
AU - Juul, K. E.
AU - Kjær, S. K.
AU - Dillner, J.
AU - Bonde, J.
PY - 2018
Y1 - 2018
N2 - BACKGROUND: Self-sampling for human papillomavirus (HPV) offered to women who do not participate in cervical cancer screening is an increasingly popular method to increase screening coverage. The rationale behind self-sampling is that unscreened women harbour a high proportion of undetected precancer lesions. Here, we compare the cervical intraepithelial neoplasia grade 2 or worse (⩾CIN2) detection rate between non-attenders who participated in self-sampling and women attending routine screening.METHODS: A total of 23 632 women who were qualified as non-attenders in the Copenhagen Region were invited for HPV-based self-sampling. Of these, 4824 women returned a self-sample, and HPV-positive women were referred for cytology and HPV co-testing as follow-up. The entire cohort and a reference cohort (3347 routinely screened women) were followed for histopathology confirmed ⩾CIN2. Odds ratio (OR) and the relative positive predictive value of ⩾CIN2 detection between the two populations were estimated.RESULTS: Women participating in self-sampling had a higher ⩾CIN2 detection than women undergoing routine cytology-based screening (OR=1.83, 95% CI: 1.21-2.77) and a similar detection as routinely screened women tested with cytology and HPV testing (OR=1.03, 95% CI: 0.75-1.40). The positive predictive value for ⩾CIN2 was higher in screening non-attenders than in routinely HPV- and cytology-screened screened women (36.5% vs 25.6%, respectively).CONCLUSIONS: Self-sampling offered to non-attenders showed higher detection rates for ⩾CIN2 than routine cytology-based screening, and similar detection rates as HPV and cytology co-testing. This reinforces the importance of self-sampling for screening non-attenders in organised cervical cancer screening.British Journal of Cancer advance online publication, 14 November 2017; doi:10.1038/bjc.2017.371 www.bjcancer.com.
AB - BACKGROUND: Self-sampling for human papillomavirus (HPV) offered to women who do not participate in cervical cancer screening is an increasingly popular method to increase screening coverage. The rationale behind self-sampling is that unscreened women harbour a high proportion of undetected precancer lesions. Here, we compare the cervical intraepithelial neoplasia grade 2 or worse (⩾CIN2) detection rate between non-attenders who participated in self-sampling and women attending routine screening.METHODS: A total of 23 632 women who were qualified as non-attenders in the Copenhagen Region were invited for HPV-based self-sampling. Of these, 4824 women returned a self-sample, and HPV-positive women were referred for cytology and HPV co-testing as follow-up. The entire cohort and a reference cohort (3347 routinely screened women) were followed for histopathology confirmed ⩾CIN2. Odds ratio (OR) and the relative positive predictive value of ⩾CIN2 detection between the two populations were estimated.RESULTS: Women participating in self-sampling had a higher ⩾CIN2 detection than women undergoing routine cytology-based screening (OR=1.83, 95% CI: 1.21-2.77) and a similar detection as routinely screened women tested with cytology and HPV testing (OR=1.03, 95% CI: 0.75-1.40). The positive predictive value for ⩾CIN2 was higher in screening non-attenders than in routinely HPV- and cytology-screened screened women (36.5% vs 25.6%, respectively).CONCLUSIONS: Self-sampling offered to non-attenders showed higher detection rates for ⩾CIN2 than routine cytology-based screening, and similar detection rates as HPV and cytology co-testing. This reinforces the importance of self-sampling for screening non-attenders in organised cervical cancer screening.British Journal of Cancer advance online publication, 14 November 2017; doi:10.1038/bjc.2017.371 www.bjcancer.com.
KW - Journal Article
U2 - 10.1038/bjc.2017.371
DO - 10.1038/bjc.2017.371
M3 - Journal article
C2 - 29136403
VL - 118
SP - 138
EP - 144
JO - The British journal of cancer. Supplement
JF - The British journal of cancer. Supplement
SN - 0007-0920
ER -
ID: 185945587