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Risk of Injuries around Diagnosis of Cervical Cancer and Its Precursor Lesions : A Nationwide Cohort Study in Sweden

Shen, Qing ; Lu, Donghao ; Andrae, Bengt ; Schelin, Maria E C LU ; Sjölander, Arvid ; Cao, Yang ; Sparén, Pär and Fang, Fang (2020) In Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology 29(11). p.2230-2234
Abstract

BACKGROUND: Highly increased risk of injuries has been noted around the time of cancer diagnosis. Whether there is a similar increase in risk around the diagnosis of cervical cancer and its precursor lesions was unknown.

METHODS: We performed a cohort study including 3,016,307 Swedish women that participated in cervical screening during 2001 to 2012. We calculated the incidence rates (IR) of hospitalized iatrogenic or noniatrogenic injuries during the diagnostic workup, and the time interval from smear or punch biopsy until surgical treatment or 2 months after the last smear or biopsy, among women with invasive cervical cancer (ICC) or its precursor lesions. We calculated the IRs of injuries during the 2 months after a normal... (More)

BACKGROUND: Highly increased risk of injuries has been noted around the time of cancer diagnosis. Whether there is a similar increase in risk around the diagnosis of cervical cancer and its precursor lesions was unknown.

METHODS: We performed a cohort study including 3,016,307 Swedish women that participated in cervical screening during 2001 to 2012. We calculated the incidence rates (IR) of hospitalized iatrogenic or noniatrogenic injuries during the diagnostic workup, and the time interval from smear or punch biopsy until surgical treatment or 2 months after the last smear or biopsy, among women with invasive cervical cancer (ICC) or its precursor lesions. We calculated the IRs of injuries during the 2 months after a normal smear among the other women as reference. IR ratios (IRR) and 95% confidence intervals (CI) were calculated using Poisson regression.

RESULTS: Compared with other women, there was an increased rate of iatrogenic injuries during the diagnostic workup of women with ICC (IR, 0.58 per 1,000 person-months; IRR, 8.55; 95% CI, 3.69-19.80) as well as of women with cervical intraepithelial neoplasia grade 3 and adenocarcinoma in situ (IR, 0.09 per 1,000 person-months; IRR, 3.04; 95% CI, 1.73-5.34). We also found an increased rate of noniatrogenic injuries during the diagnostic workup of women with invasive cancer (IR, 0.65 per 1,000 person-months; IRR, 2.48; 95% CI, 1.30-4.47).

CONCLUSIONS: Although rare, there was an increased risk of inpatient care for iatrogenic and noniatrogenic injuries during the diagnostic workup of women with ICC.

IMPACT: Women experienced burden of medical complications and psychologic distress around diagnosis of a potential cervical cancer.

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organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology
volume
29
issue
11
pages
5 pages
publisher
American Association for Cancer Research
external identifiers
  • pmid:33087343
ISSN
1538-7755
DOI
10.1158/1055-9965.EPI-20-0673
language
English
LU publication?
yes
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©2020 American Association for Cancer Research.
id
5919cd27-e398-4c6d-8d2d-bacf8d24dceb
date added to LUP
2020-11-05 13:45:10
date last changed
2020-11-06 09:05:41
@article{5919cd27-e398-4c6d-8d2d-bacf8d24dceb,
  abstract     = {<p>BACKGROUND: Highly increased risk of injuries has been noted around the time of cancer diagnosis. Whether there is a similar increase in risk around the diagnosis of cervical cancer and its precursor lesions was unknown.</p><p>METHODS: We performed a cohort study including 3,016,307 Swedish women that participated in cervical screening during 2001 to 2012. We calculated the incidence rates (IR) of hospitalized iatrogenic or noniatrogenic injuries during the diagnostic workup, and the time interval from smear or punch biopsy until surgical treatment or 2 months after the last smear or biopsy, among women with invasive cervical cancer (ICC) or its precursor lesions. We calculated the IRs of injuries during the 2 months after a normal smear among the other women as reference. IR ratios (IRR) and 95% confidence intervals (CI) were calculated using Poisson regression.</p><p>RESULTS: Compared with other women, there was an increased rate of iatrogenic injuries during the diagnostic workup of women with ICC (IR, 0.58 per 1,000 person-months; IRR, 8.55; 95% CI, 3.69-19.80) as well as of women with cervical intraepithelial neoplasia grade 3 and adenocarcinoma in situ (IR, 0.09 per 1,000 person-months; IRR, 3.04; 95% CI, 1.73-5.34). We also found an increased rate of noniatrogenic injuries during the diagnostic workup of women with invasive cancer (IR, 0.65 per 1,000 person-months; IRR, 2.48; 95% CI, 1.30-4.47).</p><p>CONCLUSIONS: Although rare, there was an increased risk of inpatient care for iatrogenic and noniatrogenic injuries during the diagnostic workup of women with ICC.</p><p>IMPACT: Women experienced burden of medical complications and psychologic distress around diagnosis of a potential cervical cancer.</p>},
  author       = {Shen, Qing and Lu, Donghao and Andrae, Bengt and Schelin, Maria E C and Sjölander, Arvid and Cao, Yang and Sparén, Pär and Fang, Fang},
  issn         = {1538-7755},
  language     = {eng},
  number       = {11},
  pages        = {2230--2234},
  publisher    = {American Association for Cancer Research},
  series       = {Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology},
  title        = {Risk of Injuries around Diagnosis of Cervical Cancer and Its Precursor Lesions : A Nationwide Cohort Study in Sweden},
  url          = {http://dx.doi.org/10.1158/1055-9965.EPI-20-0673},
  doi          = {10.1158/1055-9965.EPI-20-0673},
  volume       = {29},
  year         = {2020},
}