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Cervical cytology and the diagnosis of cervical cancer in older women.
- Source :
-
Journal of medical screening [J Med Screen] 2015 Dec; Vol. 22 (4), pp. 207-12. Date of Electronic Publication: 2015 Sep 07. - Publication Year :
- 2015
-
Abstract
- Objectives: Most non-screen-detected cervical cancers are advanced stage. We assess the potential for cytology to expedite diagnosis when used outside of routine call and recall screening for cervical cancer.<br />Methods: Two cohorts of women with cytology that did not appear to have been taken as part of routine screening, nested within a census of cervical cytology, in England between April 2007 and March 2010 were studied: 93,322 women aged 40-69 at first cytology, and 14,668 women aged ≥70. The diagnostic performance of high grade cervical squamous intraepithelial lesion (HSIL) or worse cytology was estimated. We also estimated case-fatality from stage distribution in women aged ≥66 with and without cytology in the year prior to diagnosis.<br />Results: There were 259 cancers diagnosed in women aged 40-69 at first cytology, and 78 in women aged ≥70. The sensitivity of cytology ≥ HSIL for cancer was 89% and 83% respectively, and the number of women needed to test to identify one cancer was 404 (95% confidence interval [CI]: 355-462) and 226 (95% CI: 177-292) respectively. Women aged ≥66 with cytology within a year of diagnosis had earlier stage cancers than those without, corresponding to a 17-22% reduction in case fatality.<br />Conclusions: Cervical cytology is an excellent identifier of cancer among women tested outside routine screening call and recall. Its use as a triage tool, for instance in women with vague gynaecological symptoms, could facilitate earlier stage diagnosis and reduce cervical cancer mortality.<br /> (© The Author(s) 2015.)
Details
- Language :
- English
- ISSN :
- 1475-5793
- Volume :
- 22
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Journal of medical screening
- Publication Type :
- Academic Journal
- Accession number :
- 26346038
- Full Text :
- https://doi.org/10.1177/0969141315598174