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Biomed Res Int. 2015;2015:605375. doi: 10.1155/2015/605375. Epub 2015 Jun 9.

Underscreened Women Remain Overrepresented in the Pool of Cervical Cancer Cases in Spain: A Need to Rethink the Screening Interventions.

Author information

1
Unit of Infections and Cancer, Cancer Epidemiology Research Programme, IDIBELL, Catalan Institute of Oncology (ICO), Avenida Gran Vía 199-203, L'Hospitalet de Llobregat, 08908 Barcelona, Spain.
2
Pathology Department, Hospital General de L'Hospitalet, L'Hospitalet de Llobregat, 08906 Barcelona, Spain.
3
Pathology Department, Corporació Sanitaria Parc Tauli, Sabadell, 08208 Barcelona, Spain.
4
Pathology Department, Hospital Mutua de Terrassa, Terrassa, 08221 Barcelona, Spain.
5
Pathology Department, Consorci Hospitalari de Vic, Vic, 08500 Barcelona, Spain.
6
Pathology Department, Hospital d'Althaia, Manresa, 08243 Barcelona, Spain.
7
Pathology Department, Consorci Sanitari de Terrassa, Terrassa, 08227 Barcelona, Spain.
8
Unit of Infections and Cancer, Cancer Epidemiology Research Programme, IDIBELL, Catalan Institute of Oncology (ICO), Avenida Gran Vía 199-203, L'Hospitalet de Llobregat, 08908 Barcelona, Spain ; CIBER Epidemiology and Public Health, 08036 Barcelona, Spain.

Abstract

OBJECTIVE:

Audit of women with invasive cervical cancer (CC) is critical for quality control within screening activities. We analysed the screening history in the 10 years preceding the study entry in women with and without CC during 2000-2011.

METHODS:

323 women with CC from six pathology departments in Catalonia (Spain) and 23,782 women with negative cytology were compared. Age, previous history of cytologies, and histological type and FIGO stage were collected from the pathology registries. Logistic regression analysis was used to estimate odds ratios (OR) and 95% confidence intervals (CI95%).

RESULTS:

History of cytology was registered in 26.2% of CC cases and in 78% of the control women (P < 0.0001) and its frequency decreased with increasing age. Compared to women with squamous cell carcinoma, adenocarcinoma cases were significantly more likely to have a cytology within the 3-year interval preceding cancer diagnosis (OR = 2.6 CI 95%: 1.2-5.6) and to have normal cytology results in previous screenings (OR = 2.4 CI 95%: 1.2-4.5). FIGO II-IV cases were more common among older women (older than 60 years).

CONCLUSIONS:

Absence of prior screening history was extremely common among CC cases compared to controls. Organized actions to reduce underscreened women and use of highly sensitive HPV-based tests could be important to reduce CC burden.

PMID:
26180804
PMCID:
PMC4477117
DOI:
10.1155/2015/605375
[Indexed for MEDLINE]
Free PMC Article

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