期刊
INTERNATIONAL JOURNAL OF CANCER
卷 137, 期 2, 页码 420-427出版社
WILEY
DOI: 10.1002/ijc.29381
关键词
cervical cancer; mass screening; human papillomavirus DNA test
类别
资金
- Dutch Ministry of Health, Welfare and Sports
- EC [CoheaHr 603019]
Cytological screening has substantially decreased the cervical cancer incidence, but even better protection may be achieved by primary high-risk human papillomavirus (hrHPV) screening. In the Netherlands, five-yearly cytological screening for women aged 30-60 years will be replaced by primary hrHPV screening in 2016. The new screening guidelines involve an extension of the screening interval from 5 to 10 years for hrHPV-negative women aged 40 or 50 years. We investigated the impact of this program change on the lifetime cancer risks in women without an hrHPV infection at age 30, 35, 40, 45 or 50 years. The time to cancer was estimated using 14-year follow-up data from a population-based screening intervention trial and the nationwide database of histopathology reports. The new screening guidelines are expected to lead to a reduced cervical cancer risk for all age groups. The average risk reduction was 34% and was smallest (25%) among women aged 35 years. The impact of hrHPV screening on the cancer risk was sensitive to the duration from cervical intraepithelial neoplasia grade 2/3 (CIN2/3) to cancer; a small increase in the cancer risk was estimated for women aged 35 or 40 years in case a substantial proportion of CIN2/3 showed fast progression to cancer. Our results indicate that primary hrHPV screening with a ten-yearly interval for hrHPV-negative women of age 40 and beyond will lead to a further reduction in lifetime cancer risk compared to five-yearly cytology, provided that precancerous lesions progress slowly to cancer. What's new? In 2016, a high-risk human papillomavirus (hrHPV) DNA test will replace the Pap test as primary screening instrument in the Netherlands. The screening interval for hrHPV-negative women aged 40 or 50 will expand from 5 to 10 years. This study evaluates the impact of the changes to the screening program. In light of the generally slow progression of precancerous lesions, the new screening program will reduce the long-term cervical cancer risk for women irrespective of their age in 2016.
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