Pankakoski Maiju, Sarkeala Tytti, Anttila Ahti, Heinävaara Sirpa
Finnish Cancer Registry, Unioninkatu 22, 00130 Helsinki, Finland.
Faculty of Medicine, University of Helsinki, Haartmaninkatu 8, 00014 Helsinki, Finland.
Cancers (Basel). 2022 Oct 23;14(21):5193. doi: 10.3390/cancers14215193.
In many countries with organized cervical cancer screening, opportunistic Pap and human papillomavirus (HPV) tests are common. However, little is known about their effectiveness. We examined the effect of testing in and outside the Finnish screening program on the risk of cervical cancer. We conducted a case-control study that involved 1677 cases with invasive cervical cancer that were diagnosed between 2010 and 2019. Five- and three-year test intervals were analyzed across all ages, by age group and by cancer morphology subtype. Conditional logistic regression was used, adjusting for socioeconomic variables. Women undergoing any kind of cervical test had a significantly lowered risk of cervical cancer (adjusted OR = 0.43, 95% CI = 0.38-0.48, tests in five-year intervals). The results were similar, regardless of whether the test had been taken in the screening program or outside of it, or whether the interval was five years or three years. Testing of women at ages 35-64 showed the strongest effects, but moderate preventive effects were seen until age 79. No significant effect was seen below age 30. Tests in and outside the program were effective at the screening target age. However, participation in the program should be encouraged for optimal cost-effectiveness. Preventive effects were also seen above the program target ages.
在许多开展有组织宫颈癌筛查的国家,机会性巴氏涂片检查和人乳头瘤病毒(HPV)检测很常见。然而,关于它们的有效性却知之甚少。我们研究了芬兰筛查项目内外的检测对宫颈癌风险的影响。我们进行了一项病例对照研究,纳入了2010年至2019年间确诊的1677例浸润性宫颈癌病例。分析了所有年龄段、按年龄组以及按癌症形态学亚型划分的五年和三年检测间隔情况。采用条件逻辑回归,并对社会经济变量进行了调整。接受任何一种宫颈检测的女性患宫颈癌的风险显著降低(调整后的比值比=0.43,95%置信区间=0.38 - 0.48,五年间隔检测)。无论检测是在筛查项目内还是项目外进行,也无论间隔是五年还是三年,结果都是相似的。对35 - 64岁女性的检测效果最为显著,但直到79岁都能看到中等程度的预防效果。30岁以下未观察到显著效果。项目内外的检测在筛查目标年龄是有效的。然而,为了实现最佳成本效益,应鼓励参与该项目。在项目目标年龄以上也观察到了预防效果。