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Histological outcomes in HPV-screened elderly women in Denmark

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  1. Human Papillomavirus Testing in the Last Cervical Screening Round at Age 60-64 Years

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  2. Nonalcoholic Fatty Liver Disease Impairs the Liver-Alpha Cell Axis Independent of Hepatic Inflammation and Fibrosis

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  3. HPV-prevalence in elderly women in Denmark

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  • Gry St-Martin
  • Petra Hall Viborg
  • Ane Birgitte Telén Andersen
  • Berit Andersen
  • Jette Christensen
  • Dorthe Ejersbo
  • Hanne Nørgaard Heje
  • Kirsten Marie Jochumsen
  • Tonje Johansen
  • Lise Grupe Larsen
  • Elsebeth Lynge
  • Reza Rafiolsadat Serizawa
  • Marianne Waldstrøm
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INTRODUCTION: Danish women exit cervical cancer screening at age 65 years, but 23% of cervical cancer cases occur beyond this age. In addition, due to gradual implementation of cervical cancer screening, older women are underscreened by today´s standards. A one-time screening with HPV test was therefore offered to Danish women born before 1948.

METHODS: Register based study reporting histology diagnoses and conizations in women found HPV positive in the one-time screening. Number and proportion of women with severe or non-severe histology results were calculated for screened and HPV-positive women by age group or region of residence. Number of women with biopsy and/or conization per case of cervical intraepithelial neoplasia (CIN) grade 2 or worse (CIN2+) or CIN3+ were also calculated by age groups and region.

RESULTS: 4,479 (4.1% of screened women) had positive HPV test. 94% of these had one or more additional tests. 2,785 (62%) of HPV-positive women had histology results, and conization was performed in 1,076 (24% of HPV-positive and 1% of all screened women). HPV positivity and CIN3+ detection varied little between regions, but the proportions of HPV positive women undergoing histology varied between regions from 40% to 86% and the proportion with conization from 13% to 36%. Correspondingly, the number of histologies and conizations per CIN3+ detected varied from 5.9 to 11.2 and 1.8 to 4.7, respectively. In total, 514 CIN2+ (0.47% of screened women, 11% of HPV-positive) and 337 CIN3+ (0.31% of screened women, 7.5% of HPV-positive) were diagnosed, including 37 cervical cancer cases.

DISCUSSION: HPV screening of insufficiently screened birth cohorts can potentially prevent morbidity and mortality from cervical cancer but longer follow-up is needed to see if cancer incidence declines in the screened women in the coming years. Management strategies differed among regions which influenced the proportions undergoing biopsy/conization.

Original languageEnglish
Article numbere0246902
JournalPLoS One
Volume16
Issue number2
Pages (from-to)1-12
Number of pages12
ISSN1932-6203
DOIs
Publication statusPublished - 11 Feb 2021

Bibliographical note

Publisher Copyright:
© 2021 St-Martin et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.

ID: 62244063