Do women ≥50 years of age need as much screening as women

P. Armaroli, F. Gallo, A. Bellomi, S. Ciatto, D. Consonni, D. Davi, P. Giorgi-Rossi, A. Iossa, E. Mancini, C. Naldoni, E. Polla, G. Ronco, M. Serafini, V. Vergini, L. Zanier, M. Zappa, N. Segnan

Research output: Contribution to journalArticlepeer-review

Abstract

To assess the adequacy of a routine screening to identify cervical intraepithelial neoplasia 2 or worse (CIN2+) in women over 50 years of age, a retrospective cohort was set in six Italian organised population-based screening programmes. In all, 287 330 women (1 714 550 person-years of observation, 1110 cases) screened at age 25-64, with at least two cytological screening tests, the first negative, were followed from their first negative smear until a biopsy proven CIN2+ lesion or their last negative smear. For women aged 25-49 and 50-64 years, crude and age-standardised detection rate (DR), cumulative risk (CR), adjusted hazard risk for number of previous negative screens, probability of false-positive CIN2+ after two or more smear tests were calculated. Detection rate is significantly lower over 50 years of age. Multivariable analysis shows a significant protective effect from four screening episodes (DR=0.70, 95% CI: 0.51-0.97); the effect of age ≥50 is 0.29 (95% CI: 0.24-0.35). The CR of CIN2+ is at least eightfold higher in women

Original languageEnglish
Pages (from-to)239-244
Number of pages6
JournalBritish Journal of Cancer
Volume99
Issue number2
DOIs
Publication statusPublished - Jul 22 2008

Keywords

  • Cervical intraepithelial neoplasia
  • False-positive cases
  • Mass screening
  • Middle aged
  • Vaginal smears

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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