Advanced

Randomized healthservices study of human papillomavirus-based management of low-grade cytological abnormalities.

Dillner, Lena LU ; Kemetli, Levent; Elfgren, Kristina; Bogdanovic, Gordana; Andersson, Pia LU ; Carlsten-Thor, Agneta; Andersson, Sonia; Persson, Elisabeth; Rylander, Eva and Grillner, Lena, et al. (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:
author
, et al. (More)
(Less)
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
International Journal of Cancer
volume
okt
pages
151 - 159
publisher
John Wiley & Sons
external identifiers
  • wos:000289987300015
  • pmid:20824706
  • scopus:79955411305
ISSN
0020-7136
DOI
10.1002/ijc.25649
language
English
LU publication?
yes
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
2010-10-03 20:02:32
date last changed
2017-01-08 05:23:00
@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},
  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},
  volume       = {okt},
  year         = {2011},
}