Cervical cancer screening at crossroads

Elsebeth Lynge, Carsten Rygaard, Miguel Vazquez Prada Baillet, Pierre Antoine Dugué, Bente Braad Sander, Jesper Bonde, Matejka Rebolj

Research output: Contribution to journalReview ArticleResearchpeer-review

35 Citations (Scopus)

Abstract

Cervical screening has been one of the most successful public health prevention programmes. For 50 years, cytology formed the basis for screening, and detected cervical intraepithelial lesions (CIN) were treated surgically to prevent progression to cancer. In a high-risk country as Denmark, screening decreased the incidence of cervical cancer from 34 to 11 per 100 000, age-standardized rate (World Standard Population). Screening is, however, also expensive; Denmark (population: 5.6 million) undertakes close to half a million tests per year, and has 6-8 CIN-treated women for each prevented cancer case. The discovery of human papillomavirus (HPV) as the cause of cervical cancer dramatically changed perspectives for disease control. Screening with HPV testing was launched around 1990, and preventive HPV vaccination was licensed in 2006. Long-term randomized controlled trials (RCT) demonstrated that HPV testing provides better protection against cervical cancer than cytology, but it requires extra repeated testing. HPV vaccination RCTs, furthermore, have proved that HPV vaccination protects against vaccine-type high-grade CIN in women vaccinated prior to sexual activity, but less so in women vaccinated later. The challenge now is therefore to find an algorithm for screening of a heterogeneous population including non-vaccinated women; women vaccinated prior to start of sexual activity; and women vaccinated later.

Original languageEnglish
Pages (from-to)667-673
Number of pages7
JournalAPMIS : acta pathologica, microbiologica, et immunologica Scandinavica
Volume122
Issue number8
DOIs
Publication statusPublished - 1 Jan 2014
Externally publishedYes

Keywords

  • Cancer
  • Cervix uteri
  • Cytology
  • Human papillomavirus
  • Screening

Cite this

Lynge, E., Rygaard, C., Baillet, M. V. P., Dugué, P. A., Sander, B. B., Bonde, J., & Rebolj, M. (2014). Cervical cancer screening at crossroads. APMIS : acta pathologica, microbiologica, et immunologica Scandinavica, 122(8), 667-673. https://doi.org/10.1111/apm.12279
Lynge, Elsebeth ; Rygaard, Carsten ; Baillet, Miguel Vazquez Prada ; Dugué, Pierre Antoine ; Sander, Bente Braad ; Bonde, Jesper ; Rebolj, Matejka. / Cervical cancer screening at crossroads. In: APMIS : acta pathologica, microbiologica, et immunologica Scandinavica. 2014 ; Vol. 122, No. 8. pp. 667-673.
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Lynge, E, Rygaard, C, Baillet, MVP, Dugué, PA, Sander, BB, Bonde, J & Rebolj, M 2014, 'Cervical cancer screening at crossroads', APMIS : acta pathologica, microbiologica, et immunologica Scandinavica, vol. 122, no. 8, pp. 667-673. https://doi.org/10.1111/apm.12279

Cervical cancer screening at crossroads. / Lynge, Elsebeth; Rygaard, Carsten; Baillet, Miguel Vazquez Prada; Dugué, Pierre Antoine; Sander, Bente Braad; Bonde, Jesper; Rebolj, Matejka.

In: APMIS : acta pathologica, microbiologica, et immunologica Scandinavica, Vol. 122, No. 8, 01.01.2014, p. 667-673.

Research output: Contribution to journalReview ArticleResearchpeer-review

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