PDF(Pubmed)
Abstract：
As life expectancy increases, the effectiveness of cervical cancer screening programs needs to be reassessed for the older population. We addressed the effect of test history in and outside organized screening at age 50-64 years on later cervical cancer risk. A case-control study was conducted by deriving 229 cases of 65-79 years old women with invasive cervical cancer in 2010-2019 from the Finnish Cancer Registry. Ten controls were matched for each case by birth year and hospital district. The effect of test uptake and abnormal results in 50-64 year olds on cancer risk was investigated using conditional logistic regression and adjusted for self-selection. Test uptake within the 50-64 years age group showed 75% lower odds of cervical cancer [adjusted OR (aOR) = 0.25; 95% confidence interval (95% CI), 0.18-0.35]. Untested women had 4.9 times higher odds than those tested with normal results (aOR = 4.86; 95% CI, 3.42-6.92). Having at least one abnormal test result increased the odds by 2.5 when compared with only normal results but showed lower odds when compared with untested women. The importance of testing is exhibited by the result showing a reduction of odds of cancer to one-fourth for those tested compared with untested. Similarly, receiving abnormal results was protective of cancer compared with having no tests highlighting the importance of proper follow-up. Therefore, screening history should be considered when further developing cervical cancer screening programs with special interest in non-attenders and those receiving abnormal results at older ages.
To our knowledge, this is the first study from Finnish data describing the effect of test history on later cervical cancer at older ages. Focusing on the cervical tests taken within the Finnish national screening program and outside it highlights the overall importance of having cervical tests and adds this study into the slowly increasing number of studies considering all cervical testing in Finland.
To our knowledge, this is the first study from Finnish data describing the effect of test history on later cervical cancer at older ages. Focusing on the cervical tests taken within the Finnish national screening program and outside it highlights the overall importance of having cervical tests and adds this study into the slowly increasing number of studies considering all cervical testing in Finland.
摘要：
随着预期寿命的增加,需要重新评估老年人子宫颈癌筛查计划的有效性.我们讨论了50-64岁时有组织的筛查中和外部的测试史对以后宫颈癌风险的影响。通过从芬兰癌症登记处获得2010-2019年的229例65-79岁浸润性宫颈癌患者进行了病例对照研究。每个病例按出生年份和医院区匹配10个对照。使用条件逻辑回归研究了50-64岁人群的测试摄取和异常结果对癌症风险的影响，并进行了自我选择调整。50-64岁年龄组的试验摄取显示宫颈癌的几率降低了75％[校正OR（aOR）=0.25；95％置信区间（95％CI），0.18-0.35]。未经测试的女性比正常结果的女性高出4.9倍（aOR=4.86；95％CI，3.42-6.92）。与仅正常结果相比，至少有一个异常测试结果的几率增加了2.5，但与未经测试的女性相比，显示出更低的几率。测试的重要性表现在结果显示与未测试相比，测试的癌症几率降低到四分之一。同样，与没有强调适当随访重要性的检测相比,接受异常结果对癌症具有保护作用.因此,在进一步制定宫颈癌筛查计划时，应考虑筛查史，特别是对非就诊者和年龄较大的患者有兴趣。
■据我们所知，这是芬兰数据的第一项研究，描述了测试史对老年晚期宫颈癌的影响。专注于在芬兰国家筛查计划内外进行的宫颈测试，突出了进行宫颈测试的总体重要性，并将这项研究添加到考虑芬兰所有宫颈测试的缓慢增加的研究中。
■据我们所知，这是芬兰数据的第一项研究，描述了测试史对老年晚期宫颈癌的影响。专注于在芬兰国家筛查计划内外进行的宫颈测试，突出了进行宫颈测试的总体重要性，并将这项研究添加到考虑芬兰所有宫颈测试的缓慢增加的研究中。
