|Title:||Screening frequency and atypical cells and the prediction of cervical cancer risk||Authors:||Chen Y.-Y.
|Issue Date:||2014||Journal Volume:||1003||Journal Issue:||1011||Start page/Pages:||1003-1011||Source:||Obstetrics and Gynecology||Abstract:||
OBJECTIVE: To evaluate the screening efficacy and importance of atypical squamous cells and atypical glandular cells in predicting subsequent cervical cancer risk. METHODS: This national cohort study in Taiwan analyzed associations between Pap test screening frequency and findings in 1995-2000 and subsequent risk of squamous cell carcinoma and adenocarcinoma after 2002. Women aged 30 years or older in 1995 without a cervical cancer history were included. Multivariate-adjusted hazard ratios and their 95% confidence intervals (CIs) were assessed using Cox regression analysis. RESULTS: During a total follow-up of 31,693,980 personyears in 2002-2008, 9,471 squamous cell carcinoma and 1,455 adenocarcinoma cases were newly diagnosed, resulting in 2,067 deaths. The risk of developing and dying from squamous cell carcinoma decreased significantly with increasing attendance frequency between 1995 and 2000 (all P values for trend <.001). Women who attended more than three screenings in 1995-2000 had 0.69-fold and 0.35-fold decrease in incidence and mortality of adenocarcinoma, respectively, compared with women who never attended any screenings. Abnormal cytologic findings were significant predictors of the incidence and mortality of cervical cancers. The adjusted hazard ratio (95% CI) of developing squamous cell carcinoma was 29.94 (22.83-39.25) for atypical squamous cells, cannot exclude high-grade squamous intraepithelial lesions, and the adjusted hazard ratio (95% CI) of developing adenocarcinoma was 49.43 (36.49-66.97) for atypical glandular cells. CONCLUSION: Significant reductions in cervical adenocarcinoma occurred in women who attend three or more annual screenings in 6 years. High-grade atypical squamous cells and atypical glandular cells are important predictors of subsequent adenocarcinoma and squamous cell carcinoma. ? 2014 by The American College of Obstetricians and Gynecologists. Published by Lippincott Williams & Wilkins.
|URI:||https://scholars.lib.ntu.edu.tw/handle/123456789/452728||DOI:||10.1097/AOG.0000000000000206||SDG/Keyword:||adenocarcinoma; adult; aged; article; atypical glandular cell; atypical squamous cell; cancer incidence; cancer mortality; cancer risk; cancer screening; cell type; cohort analysis; female; follow up; human; human cell; human tissue; major clinical study; Papanicolaou test; priority journal; squamous cell; Taiwan; uterine cervix adenocarcinoma; uterine cervix cancer; uterine cervix carcinoma; uterine cervix carcinoma in situ; adenocarcinoma; age; Carcinoma, Squamous Cell; early diagnosis; incidence; middle aged; mortality; pathology; register; risk factor; time; Uterine Cervical Neoplasms; vagina smear; Adenocarcinoma; Adult; Age Factors; Aged; Carcinoma, Squamous Cell; Early Detection of Cancer; Female; Humans; Incidence; Middle Aged; Papanicolaou Test; Registries; Risk Factors; Taiwan; Time Factors; Uterine Cervical Neoplasms; Vaginal Smears
|Appears in Collections:||醫學系|
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