uu.seUppsala University Publications
Change search
ReferencesLink to record
Permanent link

Direct link
Screening and cervical cancer cure: population based cohort study
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Medicinska och farmaceutiska vetenskapsområdet, centrumbildningar mm , Centre for Research and Development, Gävleborg.
Show others and affiliations
2012 (English)In: BMJ. British Medical Journal, ISSN 0959-535X, Vol. 344, e900- p.Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: To determine whether detection of invasive cervical cancer by screening results in better prognosis or merely increases the lead time until death.

DESIGN: Nationwide population based cohort study.

SETTING: Sweden.

PARTICIPANTS: All 1230 women with cervical cancer diagnosed during 1999-2001 in Sweden prospectively followed up for an average of 8.5 years.

MAIN OUTCOME MEASURES: Cure proportions and five year relative survival ratios, stratified by screening history, mode of detection, age, histopathological type, and FIGO (International Federation of Gynecology and Obstetrics) stage.

RESULTS: In the screening ages, the cure proportion for women with screen detected invasive cancer was 92% (95% confidence interval 75% to 98%) and for symptomatic women was 66% (62% to 70%), a statistically significant difference in cure of 26% (16% to 36%). Among symptomatic women, the cure proportion was significantly higher for those who had been screened according to recommendations (interval cancers) than among those overdue for screening: difference in cure 14% (95% confidence interval 6% to 23%). Cure proportions were similar for all histopathological types except small cell carcinomas and were closely related to FIGO stage. A significantly higher cure proportion for screen detected cancers remained after adjustment for stage at diagnosis (difference 15%, 7% to 22%).

CONCLUSIONS: Screening is associated with improved cure of cervical cancer. Confounding cannot be ruled out, but the effect was not attributable to lead time bias and was larger than what is reflected by down-staging. Evaluations of screening programmes should consider the assessment of cure proportions.

Place, publisher, year, edition, pages
2012. Vol. 344, e900- p.
National Category
Medical and Health Sciences
URN: urn:nbn:se:uu:diva-171939DOI: 10.1136/bmj.e900ISI: 000301231900004PubMedID: 22381677OAI: oai:DiVA.org:uu-171939DiVA: diva2:512941
Available from: 2012-03-29 Created: 2012-03-29 Last updated: 2012-04-02Bibliographically approved

Open Access in DiVA

No full text

Other links

Publisher's full textPubMed
By organisation
Centre for Research and Development, Gävleborg
In the same journal
BMJ. British Medical Journal
Medical and Health Sciences

Search outside of DiVA

GoogleGoogle Scholar
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

Altmetric score

Total: 181 hits
ReferencesLink to record
Permanent link

Direct link