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Cervical dysplasia in elderly women performing repeated self-sampling for HPV testing
Örebro University, School of Medical Sciences. Örebro University Hospital. Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden; Center for Clinical Research, Dalarna, Uppsala University, Uppsala, Sweden.ORCID iD: 0000-0002-7407-9642
Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden; Department of Oncology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden.
Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden.
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2018 (English)In: PLoS ONE, ISSN 1932-6203, E-ISSN 1932-6203, Vol. 13, no 12, article id e0207714Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: About 30% of the cervical cancer cases in Sweden occur in women older than 60. The primary aim was to evaluate the acceptability of repeated self-sampling at home for HPV-testing in elderly women. The prevalence of HPV and HPV related dysplasia as well as the sensitivity of cytology was evaluated.

METHODS: Repeated self-sampling at home for HPV testing was offered 375 women in each of the four age groups 60, 65, 70 and 75 years. Women with two consecutive positive HPV tests were examined with sampling for histology and cytology.

FINDINGS: A self-sample was provided by 59.5% (893/1500) of the invited women. The overall prevalence of HPV was 4.4% (95% CI 3.2-6.0, n = 39) in the first test, and 2.5% were persistent positive in the second test (95% C 1.6-3.8, n = 22) collected on average 5.5 months later. Dysplasia, was found in 1.8% (16/893) (95% CI 1.1-3.0) and CIN 2+ in 1.0% (9/893) (95%CI 0.5-2.0) of the women. Of the 16 women with dysplasia in histology, 13 (81.2%) had a normal cytology.

INTERPRETATION: Repeated self-sampling at home combined with HPV testing was well accepted among elderly women. A high prevalence of CIN was diagnosed by histology. Cytology showed extremely low sensitivity and should not be recommended for this age group.

Place, publisher, year, edition, pages
Public Library of Science , 2018. Vol. 13, no 12, article id e0207714
National Category
Cancer and Oncology
Identifiers
URN: urn:nbn:se:oru:diva-70620DOI: 10.1371/journal.pone.0207714ISI: 000452212400061PubMedID: 30517176Scopus ID: 2-s2.0-85057967388OAI: oai:DiVA.org:oru-70620DiVA, id: diva2:1269396
Note

Funding Agency:

Uppsala-Örebro Regional Research Council  RFR - 383351  RFR - 561251

Available from: 2018-12-10 Created: 2018-12-10 Last updated: 2019-02-01Bibliographically approved

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Lindström, Annika K.

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