Randomized healthservices study of human papillomavirus-based management of low-grade cytological abnormalities.
(2011) In International Journal of Cancer okt. p.151-159- Abstract
- Human Papillomavirus (HPV)-based management of women with borderline (ASCUS) or mildly abnormal (CINI) cervical cytology has been extensively studied in the research setting. We wished to assess safety and healthcare resource use of a real-life healthcare policy using HPV triaging.All 15 outpatient clinics involved in the organized population-based screening program in Stockholm, Sweden screening program were randomized to either continue with prior policy (colposcopy of all women with ASCUS/CINI) or to implement a policy with HPV triaging and colposcopy only of HPV-positive women. The trial enrolled the 3319 women that were diagnosed with ASCUS (n=1335) or CINI (n=1984) in Stockholm during 17(th) March 2003 to 16(th) January 2006.... (More)
- Human Papillomavirus (HPV)-based management of women with borderline (ASCUS) or mildly abnormal (CINI) cervical cytology has been extensively studied in the research setting. We wished to assess safety and healthcare resource use of a real-life healthcare policy using HPV triaging.All 15 outpatient clinics involved in the organized population-based screening program in Stockholm, Sweden screening program were randomized to either continue with prior policy (colposcopy of all women with ASCUS/CINI) or to implement a policy with HPV triaging and colposcopy only of HPV-positive women. The trial enrolled the 3319 women that were diagnosed with ASCUS (n=1335) or CINI (n=1984) in Stockholm during 17(th) March 2003 to 16(th) January 2006. Detection of high-grade cervical lesions (CINII+) and health care cost consumption was studied by registry linkages.The proportion of histopathology-verified CINII+ was similar for the 2 policies (395/1752 women (22.5%; 95% Confidence interval (CI): 20,6-24,6%) had CINII+ diagnosed with HPV triaging policy, 318/1567 women (20.3%; 95%CI: 18,3-22,4%)) had CINII+ with colposcopy policy). 64% of women with ASCUS and 77% of women with CINI were HPV-positive. HPV-positivity was age-dependent, with 81% of women below 35 years of age and 44% of women above 45 years of age testing HPV-positive. HPV triaging was cost-effective only above 35 years of age.In conclusion, a real-life randomised healthservices study of HPV triaging of women with ASCUS/CINI demonstrated similar detection of CINII+ as colposcopy of all women. (Less)
Please use this url to cite or link to this publication:
https://lup.lub.lu.se/record/1688438
- author
- organization
- publishing date
- 2011
- type
- Contribution to journal
- publication status
- published
- subject
- in
- International Journal of Cancer
- volume
- okt
- pages
- 151 - 159
- publisher
- John Wiley & Sons Inc.
- external identifiers
-
- wos:000289987300015
- pmid:20824706
- scopus:79955411305
- pmid:20824706
- ISSN
- 0020-7136
- DOI
- 10.1002/ijc.25649
- language
- English
- LU publication?
- yes
- additional info
- The information about affiliations in this record was updated in December 2015. The record was previously connected to the following departments: Respiratory Medicine and Allergology (013230111), Division of Occupational Therapy (Closed 2012) (013025000), Clinical Microbiology, Malmö (013011000)
- id
- da921792-bb33-4456-8c40-ed50b3e3b8b1 (old id 1688438)
- alternative location
- http://www.ncbi.nlm.nih.gov/pubmed/20824706?dopt=Abstract
- date added to LUP
- 2016-04-04 07:53:02
- date last changed
- 2022-05-09 01:10:17
@article{da921792-bb33-4456-8c40-ed50b3e3b8b1, abstract = {{Human Papillomavirus (HPV)-based management of women with borderline (ASCUS) or mildly abnormal (CINI) cervical cytology has been extensively studied in the research setting. We wished to assess safety and healthcare resource use of a real-life healthcare policy using HPV triaging.All 15 outpatient clinics involved in the organized population-based screening program in Stockholm, Sweden screening program were randomized to either continue with prior policy (colposcopy of all women with ASCUS/CINI) or to implement a policy with HPV triaging and colposcopy only of HPV-positive women. The trial enrolled the 3319 women that were diagnosed with ASCUS (n=1335) or CINI (n=1984) in Stockholm during 17(th) March 2003 to 16(th) January 2006. Detection of high-grade cervical lesions (CINII+) and health care cost consumption was studied by registry linkages.The proportion of histopathology-verified CINII+ was similar for the 2 policies (395/1752 women (22.5%; 95% Confidence interval (CI): 20,6-24,6%) had CINII+ diagnosed with HPV triaging policy, 318/1567 women (20.3%; 95%CI: 18,3-22,4%)) had CINII+ with colposcopy policy). 64% of women with ASCUS and 77% of women with CINI were HPV-positive. HPV-positivity was age-dependent, with 81% of women below 35 years of age and 44% of women above 45 years of age testing HPV-positive. HPV triaging was cost-effective only above 35 years of age.In conclusion, a real-life randomised healthservices study of HPV triaging of women with ASCUS/CINI demonstrated similar detection of CINII+ as colposcopy of all women.}}, author = {{Dillner, Lena and Kemetli, Levent and Elfgren, Kristina and Bogdanovic, Gordana and Andersson, Pia and Carlsten-Thor, Agneta and Andersson, Sonia and Persson, Elisabeth and Rylander, Eva and Grillner, Lena and Dillner, Joakim and Törnberg, Sven}}, issn = {{0020-7136}}, language = {{eng}}, pages = {{151--159}}, publisher = {{John Wiley & Sons Inc.}}, series = {{International Journal of Cancer}}, title = {{Randomized healthservices study of human papillomavirus-based management of low-grade cytological abnormalities.}}, url = {{http://dx.doi.org/10.1002/ijc.25649}}, doi = {{10.1002/ijc.25649}}, volume = {{okt}}, year = {{2011}}, }