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dc.contributor.advisorSkjeldestad, Finn Egil
dc.contributor.authorTverelv, Liv Reidun
dc.date.accessioned2018-09-10T10:52:01Z
dc.date.available2018-09-10T10:52:01Z
dc.date.issued2017-09-09
dc.description.abstractBackground/objective: Follow-up after histologically confirmed normal/CIN1 in cervical cancer screening is less studied. The current Norwegian follow-up guideline is combined cytology and HPV-testing after six months. The study objective is to examine compliance to guidelines and subsequent risk for CIN2+ in this subset of women. Materials and methods: Women aged 25-69 years in Troms and Finnmark counties attending the Norwegian Cervical Cancer Screening Programme were included in this registry-based cohort study. An exposed cohort with histologically confirmed normal/CIN1 after ASC-US/LSIL or ASC-H/HSIL cytologies (N=374) was compared to a control cohort having normal cytologies in primary screening (N=25,948). The exposed cohort was stratified by the first follow-up cytology being normal or abnormal. Both cohorts were followed up to the last time-point of observation of 78 months. Results: 69.5% of the exposed cohort and 42.2% of the control cohort was compliant to guidelines. The 42-month cumulative incidence of CIN2+ was, in the exposed cohort 17.9% (abnormal follow-up) and 7.1% (normal follow-up), and 0.43% in the control cohort (p < 0.01). The 42-month cumulative incidence of CIN3+ was 2.5% (95% CI: 0.0-5.2) in the exposed cohort with normal follow-up. Age-adjusted HR for CIN2+ was 22.5 (abnormal follow-up) and 9.0 (normal follow-up) (p < 0.01). Women aged 25-39 years had higher CIN2+ risks compared to women aged 55-69 years (HR 6.1, p < 0.01). Conclusion: Compliance to guidelines was better, and the cumulative incidence of CIN2+ was significantly higher among women attending follow-up after histologically confirmed normal/CIN1 compared to women having normal cytologies in primary screening. The CIN2+ risk was higher among younger women. The cumulative incidence of CIN3+ provided by a normal follow-up cytology after histologically confirmed normal/CIN1, was closely consistent to allow screening in three years. A negative co-test probably provides a risk consistent to safe return to screening within three years.en_US
dc.identifier.urihttps://hdl.handle.net/10037/13739
dc.language.isoengen_US
dc.publisherUiT Norges arktiske universiteten_US
dc.publisherUiT The Arctic University of Norwayen_US
dc.rights.accessRightsopenAccessen_US
dc.rights.holderCopyright 2017 The Author(s)
dc.rights.urihttps://creativecommons.org/licenses/by-nc-sa/3.0en_US
dc.rightsAttribution-NonCommercial-ShareAlike 3.0 Unported (CC BY-NC-SA 3.0)en_US
dc.subject.courseIDMED-3950
dc.subjectVDP::Medical disciplines: 700::Clinical medical disciplines: 750::Gynecology and obstetrics: 756en_US
dc.subjectVDP::Medisinske Fag: 700::Klinisk medisinske fag: 750::Gynekologi og obstetrikk: 756en_US
dc.titleRisk for cervical intraepithelial neoplasia grade 2 or higher (CIN2+) among women with histologically confirmed CIN1 or less in cervical cancer screeningen_US
dc.typeMaster thesisen_US
dc.typeMastergradsoppgaveen_US


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Attribution-NonCommercial-ShareAlike 3.0 Unported (CC BY-NC-SA 3.0)
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