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dc.contributor.advisorSkjeldestad, Finn Egil
dc.contributor.advisorSørbye, Sveinung Wergeland
dc.contributor.authorMsomphora, Mbachi Ruth
dc.date.accessioned2015-06-03T12:23:07Z
dc.date.available2015-06-03T12:23:07Z
dc.date.issued2015-01-05
dc.description.abstractBackground: Within the Norwegian cervical cancer screening program women were recommended biopsy after three consecutive smears of minor lesions (ASC-US/LSIL) 6-12 months apart until 2005. In 2005 the recommendations for biopsy changed to the 2nd ASC-US/LSIL, if the HPV-test was positive. In this study we determine the outcomes of secondary cervical cancer screening in two time-periods before (1996-1998) and after (2006-2008) implementation of an HPV test. Methods: This study has a historical prospective design by including in retrospect all screening- and follow-up tests for women aged 25 to 69 years old kept by the Department of Clinical Pathology, University Hospital of North Norway. All women with a first ASC-US/LSIL smear in 1996-98 and 2006-08 were identified and compared on outcomes such as proportion of cases resolved within 42 months of index smear and incidence of CIN2+. The Department of Clinical pathology has used an HPV mRNA test (NorChip PreTect HPV-Proofer) since the autumn of 2005 in secondary cervical cancer screening (triage). Results: Over the years January 1st 1991 and December 31st 2010 UNN laboratory processed 635 287 smears. After exclusion criteria, the study population comprised of 1405 women during 1996-1998 (study group A) and 738 women with a valid HPV-test in triage during 2006-2008 (study group B). In these subsets 16.2% (227/1405) in 1996-98 and 18.8% (139/738) in 2006-08 of the women were eligible for colposcopy/biopsy according to national screening recommendations. In 2006-08, when the HPV mRNA test was applied, the mean time to resolve an ASC-US/LSIL was 9.1 months (range 3-41) relative 23.1 months (range 4-42) in 1996-98 (p<0.001). Significantly more cases were solved in study group B, including HPV-testing at 1st follow-up (82.4%) compared to study group A (53.6%) within 42 months of follow-up. The positive predictive value of CIN2+ 52.0% (64/124) in study group B was significantly higher compared to that of study group A 41.7% (68/163), when there was indication for biopsy according to the screening algorithm over the time-periods. Conclusion: In triage of women with ASC-US/LSIL, the HPV mRNA test significantly reduced the time from the first abnormal cytology until biopsy and had higher predictive values compared with repeat cytology.en_US
dc.identifier.urihttps://hdl.handle.net/10037/7716
dc.identifier.urnURN:NBN:no-uit_munin_7309
dc.language.isoengen_US
dc.publisherUiT Norges arktiske universiteten_US
dc.publisherUiT The Arctic University of Norwayen_US
dc.rights.accessRightsopenAccess
dc.rights.holderCopyright 2015 The Author(s)
dc.subject.courseIDHEL-3950en_US
dc.subjectVDP:Medical disciplines: 700: Health sciences: 800en_US
dc.subjectVDP: Epidemiologi medisinsk 803en_US
dc.subjectVDP::Medisinske Fag: 700::Helsefag: 800en_US
dc.subjectVDP: Epidemiology medical: 803en_US
dc.titleTriage of women with ASC-US/LSIL cytology: the added value of implementing an HPV-testen_US
dc.typeMaster thesisen_US
dc.typeMastergradsoppgaveen_US


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