Key words: HPV; human papillomavirus; DNA; mRNA; PreTect HPV-Proofer; NASBA; PCR; ASCUS; LSIL Cytological cervical cancer screening programs have been successful in reducing the incidence of cervical cancer, even though a single conventional Papanicolaou (Pap) smear is only moderately accurate and does not achieve concurrent high sensitivity and specificity. 1,2 The management of women with atypical squamous cells of undetermined significance (ASCUS) and low-grade squamous intraepithelial lesion (LSIL) is problematic because only a small proportion will progress to cervical intraepithelial neoplasia (CIN) 3 and invasive cervical carcinoma (ICC). Histologically verified CIN has been found in 10 -60% of women with an ASCUS diagnosis, with CIN2/3 present in more than 5%. 3-11 Pap smear follow-up of women with an ASCUS smear fails to identify all women at higher risk of CIN2ϩ, suggesting that cervical cancer screening programs might benefit from implementing new diagnostic tests in the triage of women with equivocal Pap smears. 12 Infection with high-risk (HR) types of HPV is necessary for the development of ICC 13-16 and the expression of the E6/E7 oncogenes is necessary for conversion to and maintenance of malignancy in cervical tissue. [17][18][19] Therefore, detection of the E6/E7 mRNA of HR-HPV types might serve as a better risk evaluation factor than mere DNA detection for the development of high-grade squamous intraepithelial lesion (HSIL) and ICC. 20 The combination of cytology and HPV testing seems to save additional life at a reasonable cost compared to Pap testing alone. 21,22 Detection of E6/E7 mRNA can be achieved by using the commercial PreTect HPV-Proofer assay (NorChip AS, Klokkarstua, Norway), that utilizes nucleic acid sequence based amplification (NASBA).The aim of our study was to assess whether a positive HPV mRNA or DNA test at the time of an ASCUS or LSIL Pap-smear identifies women diagnosed with a histological CIN2ϩ after 2 years of follow-up. Material and methods Study subjectsThe study subjects comprise a subgroup from 4,136 women older than 30 years of age that visited a selection of gynecologists in Oslo, Norway, and have been tested in 2001 for the presence of HPV DNA by Gp5ϩ/6ϩ consensus PCR and E6/E7 transcripts by real-time multiplex NASBA (PreTect HPV-Proofer, NorChip AS) in addition to cytology. 35 PreTect HPV-Proofer detects mRNA from HPV types 16, 18, 31, 33 and 45, whereas Gp5ϩ/6ϩ consensus PCR detects HPV DNA from the L1 region in Ͼ20 HPV types. We included all women with an index Pap smear diagnosis of ASCUS or LSIL (n ϭ 77). The index Pap smear refers to the smear taken together with the HPV testing. Information on Pap smears in the 10-year period before the inclusion in our study was obtained from CRN registers. Former abnormal smears mean any smear that is not normal or unsatisfactory and has been taken before the index smear in 2001. Follow-upSeventy-seven women were followed up for 24 months in the registers of the Cancer Registry of Norway (CRN) with subsequent Pap smears...

Objective. To asses the burden and correlates of genital warts in women. Methods. We conducted a population-based cross-sectional study in 69,147 women (18 -45 years of age) randomly chosen from the general population in Denmark, Iceland, Norway, and Sweden. Information on clinically diagnosed genital warts and lifestyle habits was collected using a questionnaire.

Long-term sickness absence due to musculoskeletal health problems was strongly associated with gender, age, income, and diagnosis. Multivariate analysis indicated that the large gender differences in sickness absence might be overstated due to lack of adjustment for income and income-related factors.

Access to health data, important for population health planning, basic and clinical research and health industry utilization, remains problematic. Legislation intended to improve access to personal data across national borders has proven to be a double-edged sword, where complexity and implications from misinterpretations have paradoxically resulted in data becoming more siloed. As a result, the potential for development of health specific AI and clinical decision support tools built on real-world data have yet to be fully realized. In this perspective, we propose federated networks as a solution to enable access to diverse data sets and tackle known and emerging health problems. The perspective draws on experience from the World Economic Forum Breaking Barriers to Health Data project, the Personal Health Train and Vantage6 infrastructures, and industry insights. We first define the concept of federated networks in a healthcare context, present the value they can bring to multiple stakeholders, and discuss their establishment, operation and implementation. Challenges of federated networks in healthcare are highlighted, as well as the resulting need for and value of an independent orchestrator for their safe, sustainable and scalable implementation.

Objectives:To estimate the risk of cervical intraepithelial neoplasia (CIN) 2/3 and invasive cervical cancer (ICC) in an organised screening programme after an unsatisfactory or a normal Pap smear. Setting:A seven-year prospective cohort study of the Norwegian population-based co-ordinated screening programme based on the actual diagnostic and screening procedures performed. Observations of 526,661 women with a normal index Pap smear and 21,405 women with an unsatisfactory index Pap smear were made during 3.26 million women-years. Methods:The risk of being diagnosed with CIN 2/3 or ICC was calculated by logistic regression for the rst two years of follow-up. The hazard of being diagnosed with CIN 2/3 or ICC for the women who were not diagnosed during the two rst years was estimated by non-parametrical survival regression. Results: