TY - JOUR
T1 - Do women ≥50 years of age need as much screening as women
AU - Armaroli, P.
AU - Gallo, F.
AU - Bellomi, A.
AU - Ciatto, S.
AU - Consonni, D.
AU - Davi, D.
AU - Giorgi-Rossi, P.
AU - Iossa, A.
AU - Mancini, E.
AU - Naldoni, C.
AU - Polla, E.
AU - Ronco, G.
AU - Serafini, M.
AU - Vergini, V.
AU - Zanier, L.
AU - Zappa, M.
AU - Segnan, N.
PY - 2008/7/22
Y1 - 2008/7/22
N2 - 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
AB - 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
KW - Cervical intraepithelial neoplasia
KW - False-positive cases
KW - Mass screening
KW - Middle aged
KW - Vaginal smears
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U2 - 10.1038/sj.bjc.6604455
DO - 10.1038/sj.bjc.6604455
M3 - Article
C2 - 18594534
AN - SCOPUS:48249139837
VL - 99
SP - 239
EP - 244
JO - British Journal of Cancer
JF - British Journal of Cancer
SN - 0007-0920
IS - 2
ER -