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Age at time of first intercourse v. chronologic age as a basis for Pap smear screening.

https://arctichealth.org/en/permalink/ahliterature243029
Source
Can Med Assoc J. 1982 Jul 15;127(2):127-31
Publication Type
Article
Date
Jul-15-1982
Author
V C Wright
M A Riopelle
Source
Can Med Assoc J. 1982 Jul 15;127(2):127-31
Date
Jul-15-1982
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Factors
Carcinoma in Situ - diagnosis - epidemiology
Coitus
Female
Humans
Mass Screening
Middle Aged
Ontario
Papanicolaou test
Time Factors
Uterine Cervical Dysplasia - diagnosis - epidemiology
Uterine Cervical Neoplasms - epidemiology - etiology
Vaginal Smears
Abstract
The Walton Report on cervical cancer screening programs recently recommended a new program for screening for cervical cancer based on chronologic age, calling for 3- and 5-year intervals between examinations. It recommended that such examinations be discontinued after 60 years of age. In a group of 232 routinely examined women (aged 18 to 47 years) in whom cervical intraepithelial neoplasia developed the timing of onset of the disease and the implications for screening were studied. The average age at the time of diagnosis was 30 years; in 20% of the patients the diagnosis had been made after age 35. The screening program recommended in the Walton Report would have been effective in diagnosing most cases (80%) in this sample by age 35 and all by age 60. However, when the patients were grouped according to age at the time of first intercourse, the diagnosis had been made after age 35 in only 13% of those who started having intercourse at age 15 to 17 years, 20% of those who started at age 18 to 19 years and 33% of those who started at age 20 years of later. When the times of diagnosis were expressed by number of years of intercourse the distributions became uniform in the same three groups; in 72% of all the patients the diagnosis had been made within the first 15 years of intercourse, in 88% it had been made within 20 years and in 100% it had been made by 30 years. These data suggest that a program based on number of years of intercourse may be more uniform and more efficient than one based on chronologic age, and that cytologic examinations should be concentrated during the time when most cases develop -- 6 to 20 years after the time of first intercourse.
Notes
Cites: JAMA. 1960 Dec 3;174(14):1847-5112259009
Cites: Lancet. 1965 Oct 16;2(7416):756-94157809
Cites: Aust N Z J Obstet Gynaecol. 1966 Feb;6(1):30-45218307
Cites: Cancer Chemother Rep. 1966 Mar;50(3):163-705910392
Cites: Am J Public Health Nations Health. 1967 May;57(5):840-76067208
Cites: Cancer Res. 1967 Apr;27(4):603-176025727
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Cites: Cancer. 1968 Apr;21(4):663-715643761
Cites: Cancer Res. 1968 Apr;28(4):695-7065649059
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Cites: Am J Epidemiol. 1969 May;89(5):547-545818824
Cites: Am J Obstet Gynecol. 1969 Oct 1;105(3):386-935810787
Cites: Am J Obstet Gynecol. 1976 Sep 1;126(1):110-5961736
Cites: Am J Obstet Gynecol. 1976 Oct 15;126(4):418-21984102
Cites: Am J Obstet Gynecol. 1978 Jul 15;131(6):620-3581144
Cites: Proc R Soc Lond B Biol Sci. 1980 Nov 19;210(1180):411-216109302
Cites: Acta Cytol. 1965 Jul-Sep;9:314-614336995
PubMed ID
7093858 View in PubMed
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Asymptomatic breast cancer in non-participants of the national screening programme in Norway: a confounding factor in evaluation?

https://arctichealth.org/en/permalink/ahliterature128414
Source
J Med Screen. 2012 Dec;19(4):177-83
Publication Type
Article
Date
Dec-2012
Author
Solveig R Hoff
Olbjørn Klepp
Solveig Hofvind
Author Affiliation
Department of Radiology, Aalesund Hospital, Helse Møre og Romsdal HF, NO-6026 Aalesund, Norway. sorohoff@gmail.com
Source
J Med Screen. 2012 Dec;19(4):177-83
Date
Dec-2012
Language
English
Publication Type
Article
Keywords
Aged
Algorithms
Asymptomatic Diseases - epidemiology
Breast Neoplasms - diagnosis - epidemiology
Carcinoma in Situ - diagnosis - epidemiology
Carcinoma, Ductal, Breast - diagnosis - epidemiology
Confounding Factors (Epidemiology)
Early Detection of Cancer
Female
Health Status Indicators
Humans
Mass Screening - methods - statistics & numerical data
Middle Aged
National Health Programs
Norway - epidemiology
Patient Participation - psychology - statistics & numerical data
Prognosis
Abstract
To evaluate the extent and histopathological characteristics of asymptomatic breast cancer detected outside the Norwegian Breast Cancer Screening Program (NBCSP) in women targeted by the programme.
Our study included 568 primary breast cancers (523 invasive and 45 ductal carcinoma in situ) diagnosed in 553 women aged 50-70, residing in Møre og Romsdal County, 2002-2008. The cancers were divided into screening-detected cancers in the NBCSP, interval cancers (ICs) and cancers detected in women not participating in the NBCSP (never participated and lapsed attendees), and further into asymptomatic and symptomatic cancers. Nottingham Prognostic Index (NPI) was used for comparisons across the groups and the distributions were compared using chi-square tests for statistical significance.
Twenty percent (19/97) of the ICs and 32% (69/213) of the breast cancers in non-participants were asymptomatic, with opportunistic screening as the most frequent detection method (42%, 8/19 for ICs and 54%, 37/69 for non-participants). There were no differences in distribution of NPI prognostic categories across subgroups of asymptomatic invasive cancers (screening-detected cancers in the NBCSP, asymptomatic ICs and asymptomatic cancers in non-participants) or between subgroups of symptomatic invasive cancers (symptomatic ICs and symptomatic cancers in non-participants). Asymptomatic cancers had a significantly more favourable distribution of NPI prognostic categories compared with symptomatic cancers (P
PubMed ID
23486698 View in PubMed
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Breast carcinoma in situ in 167 women--incidence, mode of presentation, therapy and follow-up.

https://arctichealth.org/en/permalink/ahliterature24724
Source
Eur J Surg Oncol. 1991 Oct;17(5):466-76
Publication Type
Article
Date
Oct-1991
Author
A. Ringberg
I. Andersson
K. Aspegren
F. Linell
Author Affiliation
Department of Plastic and Reconstructive Surgery, Lund University, Malmö General Hospital, Sweden.
Source
Eur J Surg Oncol. 1991 Oct;17(5):466-76
Date
Oct-1991
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Biopsy, Needle
Breast Neoplasms - diagnosis - epidemiology - surgery
Carcinoma in Situ - diagnosis - epidemiology - surgery
Carcinoma, Intraductal, Noninfiltrating - diagnosis - epidemiology - surgery
Female
Follow-Up Studies
Humans
Incidence
Mammography
Mass Screening
Middle Aged
Retrospective Studies
Sweden - epidemiology
Abstract
In the city of Malmö, in southern Sweden, 1693 women were diagnosed as having breast carcinoma during 1976 through 1984. Of these, 167 women had pure in situ breast carcinoma (9.9%). One hundred and thirty-two had ductal carcinoma in situ (DCIS) alone or in combination with lobular carcinoma in situ (LCIS), intracystic carcinoma and/or Paget's disease of the nipple. Thirty-three had pure LCIS and two had pure intracystic carcinomas. The incidence of breast carcinoma in situ (CIS) in women 20 years of age or older was 18.7 per 10(5) woman years with high rates of DCIS for all ages above 40, whereas a decline in incidence rate was seen for LCIS in the postmenopausal age groups. The ratio of DCIS to LCIS was 4:1. Of the 132 patients with DCIS, 46% were asymptomatic and were diagnosed by mammography, 35% presented with clinical symptoms, and 19% of the cases were incidental findings in breasts operated on for benign lesions. Mammography had been performed on all patients with DCIS and contributed to diagnosis in 75%. Sixty-one per cent of all DCIS lesions had microcalcifications suspicious for carcinoma. Eighty-nine of 132 patients with DCIS underwent fine-needle aspiration biopsy (FNAB) before surgical biopsy. FNAB was suspicious or diagnostic for carcinoma in 57/89 (64%). Of 33 cases with LCIS all but one were incidental findings. In one of 28 cases with LCIS examined by mammography there was suspicion of carcinoma. Sixteen per cent of the patients with DCIS were treated by a breast-conserving operation (BCO), the remaining patients by mastectomy (ME) (52%) or subcutaneous mastectomy (SCM) (33%) with immediate reconstruction. Thirty-three per cent of the patients with LCIS were treated by BCO, the remaining patients by ME (18%) or SCM (49%) with immediate reconstruction. Only one patient had radiotherapy postoperatively. In 60% of all CIS cases where an excisional biopsy had been performed there were further foci of CIS in the final ME/SCM specimen. After a median follow-up of 7 years for the DCIS group, three patients out of 21 treated by BCO had invasive carcinoma appearing ipsilaterally. They were alive and without symptoms of recurrent disease 2.5 to 6 years following further surgery. One patient treated by SCM died from generalized ductal breast carcinoma. In the LCIS group (median follow-up 8 years) one patient out of 11 had an invasive tubular carcinoma diagnosed 4 years after BCO. Eight years later she was alive and well after bilateral SCM.
PubMed ID
1657650 View in PubMed
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Cervical cancers in Greenlandic women diagnosed after negative results on cervical cytology: perspectives in a high-risk population.

https://arctichealth.org/en/permalink/ahliterature24024
Source
APMIS. 1993 Jun;101(6):492-6
Publication Type
Article
Date
Jun-1993
Author
N H Nielsen
H. Jensen
Author Affiliation
Institute of Forensic Pathology, Copenhagen University, Denmark.
Source
APMIS. 1993 Jun;101(6):492-6
Date
Jun-1993
Language
English
Publication Type
Article
Keywords
Adenocarcinoma - diagnosis - epidemiology
Adult
Age Factors
Aged
Carcinoma in Situ - diagnosis - epidemiology
Carcinoma, Squamous Cell - diagnosis - epidemiology
Cervix Uteri - pathology
False Negative Reactions
Female
Follow-Up Studies
Greenland - epidemiology
Humans
Incidence
Middle Aged
Risk factors
Uterine Cervical Neoplasms - diagnosis - epidemiology
Vaginal Smears
Abstract
A total of 160 indigenous Greenlandic women had incident cervical cancer diagnosed during 1976-1991, and 41 of these women (27%) had had at least one negative smear reported during the 10 years preceding the diagnosis of cancer. Thirteen patients had previously had abnormalities of the cervix. Of the remaining 28 patients, 17 had so-called interval cancer diagnosed within three years after a negative smear result. In seven of these cases, representing 4% of all incident cancers during the period, there had previously been two or more negative smears. Suboptimal sampling of negative smears was suggested in roughly one out of two interval cancers. The results suggest that rapid biological development of cervical cancer is infrequent among Greenlandic females and that efforts should be aimed at increasing the smear test's sensitivity and providing a better follow-up of women with cervical abnormalities rather than shortening the three-year rescreening interval.
PubMed ID
8363826 View in PubMed
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Cervical cytology in Greenland and occurrence of cervical carcinoma, carcinoma in situ, and dysplasia. Extent and impact of uncoordinated screening activity 1976-1985.

https://arctichealth.org/en/permalink/ahliterature25774
Source
Arctic Med Res. 1988 Oct;47(4):179-88
Publication Type
Article
Date
Oct-1988

[Clinical aspects and treatment of "minimal" forms of breast cancer].

https://arctichealth.org/en/permalink/ahliterature242555
Source
Vopr Onkol. 1983;29(5):28-33
Publication Type
Article
Date
1983
Author
V F Semiglazov
A A Orlov
Source
Vopr Onkol. 1983;29(5):28-33
Date
1983
Language
Russian
Publication Type
Article
Keywords
Adult
Aged
Breast Neoplasms - diagnosis - epidemiology - therapy
Carcinoma in Situ - diagnosis - epidemiology
Carcinoma, Intraductal, Noninfiltrating - diagnosis - epidemiology
Female
Humans
Mass Screening
Middle Aged
Neoplasm Metastasis
Neoplasm Recurrence, Local - epidemiology
Precancerous Conditions - diagnosis - epidemiology - therapy
Russia
Terminology as Topic
Urban Population
Abstract
The data on 262 patients with minimal breast cancer (less than 1 cm in diameter) are presented. The long-term results of treatment of this group were good: 5- and 10-year survival rates were 91.2 and 79.5%, respectively. However, minimal breast cancer tended to produce regional (28.5%) and distant (10.3%) metastases. Organ-saving operation, viz. lumpectomy en bloc with axillary-subclavian adipose tissue was frequently (18.5%) followed by local and regional recurrence development. Adjuvant thiotepa therapy caused a 17.8% decrease in the frequency of recurrence and distant metastases development.
PubMed ID
6305033 View in PubMed
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Detection of preinvasive cancer of the cervix and the subsequent reduction in invasive cancer.

https://arctichealth.org/en/permalink/ahliterature23981
Source
J Natl Cancer Inst. 1993 Jul 7;85(13):1050-7
Publication Type
Article
Date
Jul-7-1993
Author
R. Bergström
H O Adami
L. Gustafsson
J. Pontén
P. Sparén
Author Affiliation
Department of Statistics, Uppsala University, Sweden.
Source
J Natl Cancer Inst. 1993 Jul 7;85(13):1050-7
Date
Jul-7-1993
Language
English
Publication Type
Article
Keywords
Adult
Aged
Carcinoma in Situ - diagnosis - epidemiology
Female
Humans
Incidence
Mass Screening
Middle Aged
Models, Statistical
Neoplasm Invasiveness
Registries
Regression Analysis
Research Support, Non-U.S. Gov't
Sweden - epidemiology
Uterine Cervical Neoplasms - diagnosis - epidemiology - prevention & control
Vaginal Smears
Abstract
BACKGROUND: Cytologic screening and follow-up can reduce the incidence of cervical cancer by detection and removal of precursor lesions. It is unknown, however, whether differences in histopathologic criteria for these precursor lesions affect the benefit of screening. These criteria may be difficult to study, but they are likely to be reflected in reported incidence of in situ cancer in small areas of Sweden. PURPOSE: Our purpose was to test the hypothesis that the benefit of screening can be predicted by histopathologic criteria as reflected in the reported incidence of cancer in situ. METHODS: Incidence data were from the Swedish National Cancer Registry. Regression models showing the relationship between in situ and invasive cancer were formulated and estimated. Each county (total, 24) was a unit of measurement, and adjustment was made for the incidence of invasive cancer before screening. RESULTS: During population-based screening in Sweden, the incidence of cancer in situ varied about fourfold among the 24 counties, which indicates that the criteria used to diagnose cancer in situ differed markedly. No statistically significant (P
Notes
Comment In: J Natl Cancer Inst. 1993 Jul 7;85(13):1018-98515480
PubMed ID
8515491 View in PubMed
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[Laryngeal carcinomas and precancerous lesions. Incidence and course in a local area]

https://arctichealth.org/en/permalink/ahliterature20015
Source
Ugeskr Laeger. 2000 Dec 4;162(49):6683-6
Publication Type
Article
Date
Dec-4-2000
Author
A. Walsted
E V Andersen
A S Berner
I H Keller
Author Affiliation
Øre-naese-halsafdeling E, Amtssygehuset i Glostrup.
Source
Ugeskr Laeger. 2000 Dec 4;162(49):6683-6
Date
Dec-4-2000
Language
Danish
Publication Type
Article
Keywords
Carcinoma - diagnosis - epidemiology - mortality - pathology
Carcinoma in Situ - diagnosis - epidemiology - mortality - pathology
Denmark - epidemiology
English Abstract
Female
Follow-Up Studies
Glottis - pathology
Humans
Incidence
Laryngeal Neoplasms - diagnosis - epidemiology - mortality - pathology
Laryngoscopy
Male
Neoplasm Staging
Precancerous Conditions - diagnosis - epidemiology - mortality - pathology
Prognosis
Research Support, Non-U.S. Gov't
Survival Rate
Abstract
Out of 464 laryngoscopies, 23 patients with premalignant and 55 with malignant laryngeal biopsies were followed-up ten years later. Thirteen of the precancerous became malignant, ten within three months, and three after years. All with severe dysplasia later developed a carcinoma. Most male patients (66%) had glottic carcinomas while most female patients (88%) had supraglottic carcinomas. The incidence of larynx carcinomas was significantly higher and the disease specific survival lower in our area than in the rest of Denmark. Crude survival for glottic and supraglottic carcinomas was nearly equal after ten years (36%), but patients with glottic carcinomas had a higher death rate due to other causes. Social factors are suggested to be responsible for this. In 1994-1996 a smaller proportion of patients with glottic carcinomas were diagnosed in stage I, but the overall incidence was a little lower.
PubMed ID
11188056 View in PubMed
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Low proportion of false-negative smears in the Finnish program for cervical cancer screening.

https://arctichealth.org/en/permalink/ahliterature145542
Source
Cancer Epidemiol Biomarkers Prev. 2010 Feb;19(2):381-7
Publication Type
Article
Date
Feb-2010
Author
Stefan Lönnberg
Ahti Anttila
Laura Kotaniemi-Talonen
Harry Kujari
Jukka Melkko
Gustav Granroth
Martine Vornanen
Timo Pietiläinen
Anna Sankila
Johanna Arola
Tapio Luostarinen
Pekka Nieminen
Author Affiliation
Finnish Cancer Registry, Helsinki, Finland. stefan.lonnberg@cancer.fi
Source
Cancer Epidemiol Biomarkers Prev. 2010 Feb;19(2):381-7
Date
Feb-2010
Language
English
Publication Type
Article
Keywords
Adult
Carcinoma in Situ - diagnosis - epidemiology
False Negative Reactions
Female
Finland
Humans
Middle Aged
Reproducibility of Results
Retrospective Studies
Sensitivity and specificity
Uterine Cervical Neoplasms - diagnosis - epidemiology
Vaginal Smears
Abstract
We assessed the performance and validity of cytology in the Finnish screening program by considering high-grade neoplasia and cervical cancer (CIN3+) rates as detected in the program and by reevaluating cases observed after a negative screening test.
This retrospective study included 915 screen-detected CIN3+ cases and 421 cases observed after a negative screen. Randomized and blinded reevaluation of potential false-negative screening tests covered 345 archival case smears from women without a referral to colposcopy, as well as 689 control smears for estimating performance and validity measures.
The false-negative rate at the cutoff of low-grade squamous intraepithelial lesion or worse was 35% (95% confidence interval, 30-40%). In the subpopulation with original screening result of Pap I, the false-negative rate was 23% (18-28%). Sensitivity of screening laboratory rereading for detecting low-grade lesions or worse as atypical was 75% (67-82%) and specificity 93% (91-94%). Reproducibility of specific cytologic diagnoses was only fair. False negatives constituted 11% of all CIN3+ diagnoses in the screened population; those false negatives with an original Pap I screening result constituted 5%.
Although screen failures in the form of diagnostic false negatives occur within the Finnish screening program, their effect on cancer incidence is fairly small and cannot be readily decreased without sacrificing the high specificity of screening or without high incremental costs. Feedback for the screening laboratories is needed, however, to improve the reproducibility of cytologic diagnoses to optimize the burden of intensified follow-up and treatment of precancerous lesions.
PubMed ID
20142239 View in PubMed
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20 records – page 1 of 2.