Screening-Preventable Cervical Cancer Risks: Evidence From a Nationwide Audit in Sweden
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 effec...
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| Published in | JNCI : Journal of the National Cancer Institute Vol. 100; no. 9; pp. 622 - 629 |
|---|---|
| Main Authors | , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
Cary, NC
Oxford University Press
07.05.2008
Oxford Publishing Limited (England) |
| Subjects | |
| Online Access | Get full text |
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| Abstract | 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. |
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| AbstractList | 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 (P-homogeneity = .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. 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 (P homogeneity = .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. 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.BACKGROUNDThe 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.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.METHODSWe 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.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 (P(homogeneity) = .96). The risk for non-squamous 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.RESULTSWomen 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 (P(homogeneity) = .96). The risk for non-squamous 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.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 non-squamous cancers.CONCLUSIONSNonadherence 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 non-squamous cancers. 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. 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. [PUBLICATION ABSTRACT] 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 (P sub(homogeneity) = .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. 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 (P(homogeneity) = .96). The risk for non-squamous 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 non-squamous cancers. 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. 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. 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 (P(homogeneity) = .96). The risk for non-squamous 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. 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 non-squamous cancers. 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. |
| Author | Andrae, Bengt Törnberg, Sven Silfverdal, Lena Dillner, Joakim Kemetli, Levent Strander, Björn Ryd, Walter Sparén, Pär |
| Author_xml | – sequence: 1 givenname: Bengt surname: Andrae fullname: Andrae, Bengt email: bengt.andrae@gmail.com organization: Affiliations of authors: Department of Obstetrics and Gynecology, Gävle Hospital, Gävle, Sweden (BA); Cancer Screening Unit, Oncologic Center M8, Karolinska University Hospital, Stockholm, Sweden (LK, ST); Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden (PS); Department of Obstetrics and Gynecology, Umeå University Hospital, Umeå, Sweden (LS); Oncologic center, Western Region, Sahlgrenska University Hospital, Göteborg, Sweden (BS); Department of Pathology and Clinical Cytology, Sahlgrenska University Hospital, Göteborg, Sweden (WR); Department of Medical Microbiology, Lund University, University Hospital, Malmö, Sweden (JD) – sequence: 2 givenname: Levent surname: Kemetli fullname: Kemetli, Levent organization: Affiliations of authors: Department of Obstetrics and Gynecology, Gävle Hospital, Gävle, Sweden (BA); Cancer Screening Unit, Oncologic Center M8, Karolinska University Hospital, Stockholm, Sweden (LK, ST); Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden (PS); Department of Obstetrics and Gynecology, Umeå University Hospital, Umeå, Sweden (LS); Oncologic center, Western Region, Sahlgrenska University Hospital, Göteborg, Sweden (BS); Department of Pathology and Clinical Cytology, Sahlgrenska University Hospital, Göteborg, Sweden (WR); Department of Medical Microbiology, Lund University, University Hospital, Malmö, Sweden (JD) – sequence: 3 givenname: Pär surname: Sparén fullname: Sparén, Pär organization: Affiliations of authors: Department of Obstetrics and Gynecology, Gävle Hospital, Gävle, Sweden (BA); Cancer Screening Unit, Oncologic Center M8, Karolinska University Hospital, Stockholm, Sweden (LK, ST); Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden (PS); Department of Obstetrics and Gynecology, Umeå University Hospital, Umeå, Sweden (LS); Oncologic center, Western Region, Sahlgrenska University Hospital, Göteborg, Sweden (BS); Department of Pathology and Clinical Cytology, Sahlgrenska University Hospital, Göteborg, Sweden (WR); Department of Medical Microbiology, Lund University, University Hospital, Malmö, Sweden (JD) – sequence: 4 givenname: Lena surname: Silfverdal fullname: Silfverdal, Lena organization: Affiliations of authors: Department of Obstetrics and Gynecology, Gävle Hospital, Gävle, Sweden (BA); Cancer Screening Unit, Oncologic Center M8, Karolinska University Hospital, Stockholm, Sweden (LK, ST); Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden (PS); Department of Obstetrics and Gynecology, Umeå University Hospital, Umeå, Sweden (LS); Oncologic center, Western Region, Sahlgrenska University Hospital, Göteborg, Sweden (BS); Department of Pathology and Clinical Cytology, Sahlgrenska University Hospital, Göteborg, Sweden (WR); Department of Medical Microbiology, Lund University, University Hospital, Malmö, Sweden (JD) – sequence: 5 givenname: Björn surname: Strander fullname: Strander, Björn organization: Affiliations of authors: Department of Obstetrics and Gynecology, Gävle Hospital, Gävle, Sweden (BA); Cancer Screening Unit, Oncologic Center M8, Karolinska University Hospital, Stockholm, Sweden (LK, ST); Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden (PS); Department of Obstetrics and Gynecology, Umeå University Hospital, Umeå, Sweden (LS); Oncologic center, Western Region, Sahlgrenska University Hospital, Göteborg, Sweden (BS); Department of Pathology and Clinical Cytology, Sahlgrenska University Hospital, Göteborg, Sweden (WR); Department of Medical Microbiology, Lund University, University Hospital, Malmö, Sweden (JD) – sequence: 6 givenname: Walter surname: Ryd fullname: Ryd, Walter organization: Affiliations of authors: Department of Obstetrics and Gynecology, Gävle Hospital, Gävle, Sweden (BA); Cancer Screening Unit, Oncologic Center M8, Karolinska University Hospital, Stockholm, Sweden (LK, ST); Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden (PS); Department of Obstetrics and Gynecology, Umeå University Hospital, Umeå, Sweden (LS); Oncologic center, Western Region, Sahlgrenska University Hospital, Göteborg, Sweden (BS); Department of Pathology and Clinical Cytology, Sahlgrenska University Hospital, Göteborg, Sweden (WR); Department of Medical Microbiology, Lund University, University Hospital, Malmö, Sweden (JD) – sequence: 7 givenname: Joakim surname: Dillner fullname: Dillner, Joakim organization: Affiliations of authors: Department of Obstetrics and Gynecology, Gävle Hospital, Gävle, Sweden (BA); Cancer Screening Unit, Oncologic Center M8, Karolinska University Hospital, Stockholm, Sweden (LK, ST); Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden (PS); Department of Obstetrics and Gynecology, Umeå University Hospital, Umeå, Sweden (LS); Oncologic center, Western Region, Sahlgrenska University Hospital, Göteborg, Sweden (BS); Department of Pathology and Clinical Cytology, Sahlgrenska University Hospital, Göteborg, Sweden (WR); Department of Medical Microbiology, Lund University, University Hospital, Malmö, Sweden (JD) – sequence: 8 givenname: Sven surname: Törnberg fullname: Törnberg, Sven organization: Affiliations of authors: Department of Obstetrics and Gynecology, Gävle Hospital, Gävle, Sweden (BA); Cancer Screening Unit, Oncologic Center M8, Karolinska University Hospital, Stockholm, Sweden (LK, ST); Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden (PS); Department of Obstetrics and Gynecology, Umeå University Hospital, Umeå, Sweden (LS); Oncologic center, Western Region, Sahlgrenska University Hospital, Göteborg, Sweden (BS); Department of Pathology and Clinical Cytology, Sahlgrenska University Hospital, Göteborg, Sweden (WR); Department of Medical Microbiology, Lund University, University Hospital, Malmö, Sweden (JD) |
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| Snippet | Background The effectiveness of cervical cancer screening programs differs widely in different populations. The reasons for these differences are unclear.... Background The effectiveness of cervical cancer screening programs differs widely in different populations. The reasons for these differences are unclear.... The effectiveness of cervical cancer screening programs differs widely in different populations. The reasons for these differences are unclear. Routine and... Background: The effectiveness of cervical cancer screening programs differs widely in different populations. The reasons for these differences are unclear.... BACKGROUND: The effectiveness of cervical cancer screening programs differs widely in different populations. The reasons for these differences are unclear.... |
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| SubjectTerms | Adenocarcinoma - diagnosis Adenocarcinoma - prevention & control Adenocarcinoma/diagnosis/prevention & control Adult Audits Biological and medical sciences Cancer and Oncology Cancer och onkologi Carcinoma, Squamous Cell - diagnosis Carcinoma, Squamous Cell - prevention & control Case-Control Studies Cervical cancer Clinical Medicine Disease prevention Effectiveness studies Female Female genital diseases Gynecology. Andrology. Obstetrics Humans Incidence Klinisk medicin Logistic Models Mass Screening - methods Mass Screening - standards Mass Screening/methods/standards Medical and Health Sciences Medical Audit Medical sciences Medical screening Medicin och hälsovetenskap Middle Aged Neoplasm Staging Odds Ratio Papanicolaou Test Primary Prevention - methods Program Evaluation Registries Risk Assessment Risk Factors Sweden - epidemiology Treatment Refusal Tumors Uterine Cervical Neoplasms - diagnosis Uterine Cervical Neoplasms - epidemiology Uterine Cervical Neoplasms - pathology Uterine Cervical Neoplasms - prevention & control Uterine Cervical Neoplasms/diagnosis/epidemiology/pathology/prevention & control Vaginal Smears |
| Title | Screening-Preventable Cervical Cancer Risks: Evidence From a Nationwide Audit in Sweden |
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