Exploring the trend of increased cervical intraepithelial neoplasia detection rates in the Netherlands

Rozemeijer, Kirsten; Kemenade, Folkert J. van; Penning, Corine; Matthijsse, Suzette M.; Naber, Steffie K.; Rosmalen, Joost van; Ballegooijen, Marjolein van; Kok, Inge M.C.M. de

doi:10.1177/0969141315580836

Cited by 10 publications

(14 citation statements)

References 15 publications

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“…In addition, the HPV test, which was introduced in 2005 for triage of women with low‐grade cytological abnormalities (atypical cells of undetermined significance or low‐grade squamous intraepithelial lesions), has improved the sensitivity of the NCCSP and detection of precancerous lesions . Increasing patterns of cervical precancerous lesions, similar to those we observed in Norway, have also been described in nationwide studies from Denmark and the Netherlands . The observed changes were attributed mostly to the increased use of LBC.…”

Section: Discussionsupporting

confidence: 72%

“…26 Increasing patterns of cervical precancerous lesions, similar to those we observed in Norway, have also been described in nationwide studies from Denmark 27 and the Netherlands. 28 The observed changes were attributed mostly to the increased use of LBC. However, these countries also started to use automation-assisted LBC reading, while in Norway all cytology tests are manually read and interpreted.…”

Section: Discussionmentioning

confidence: 99%

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Recent increase in incidence of cervical precancerous lesions in Norway: Nationwide study from 1992 to 2016

Orumaa

Leinonen

Campbell

et al. 2019

Intl Journal of Cancer

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We analysed patterns in the incidence of cervical intraepithelial neoplasia grades 2 and 3 (CIN2, CIN3) and adenocarcinoma in situ (AIS) by age and histology in 1992–2016 in Norway and described changes in screening tests. Incident cases of CIN2, CIN3, AIS and cervical cancer were identified in the Cancer Registry of Norway, as were all women with at least one screening test. The annual percentage change statistic was used to assess point estimates and changes in age‐specific and age‐standardised incidence rates (IR). Women aged 25–29 years had the highest incidence of cervical precancerous lesions (CIN2: 192.9/10, CIN3: 737.2/10, AIS: 32.5/105 in 2016). The IR of CIN2 increased for all screening ages (25–69 years) from 3.6% to 6.7% per year. CIN3 incidence increased by 1.6% (95% confidence interval [CI] 0.6–2.6) annually. A steep increase in AIS incidence was observed in all age groups (7.1% per year, 95% CI 5.3–8.8). Changes in screening tests and the histological verification of cervical precancerous lesions alone cannot explain the steady increase in incidence we observed over the 25‐year study period, and increased exposure to human papillomavirus (HPV) likely plays a role. Age‐appropriate treatment of screening‐detected cervical precancerous lesions is needed for effective cervical cancer control while avoiding overtreatment and related health risks. In order to perform an appropriate harm‐benefit evaluation of cervical cancer control efforts, detailed information on screening technology and background risks, including HPV vaccination status, is needed to create optimal public health policy.

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Section: Discussionsupporting

confidence: 72%

Section: Discussionmentioning

confidence: 99%

Recent increase in incidence of cervical precancerous lesions in Norway: Nationwide study from 1992 to 2016

Orumaa

Leinonen

Campbell

et al. 2019

Intl Journal of Cancer

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“…A possible explanation for this is the increased detection rate for CIN in the Netherlands, as found by Rozemeijer et al. during 2000–2011. The authors contribute this increase to the implementation of liquid‐based cytology, but also an increased cervical cancer risk, which was confirmed by this study.…”

Section: Discussionmentioning

confidence: 88%

Increasing incidence of invasive and in situ cervical adenocarcinoma in the Netherlands during 2004–2013

et al. 2017

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In the developed world, the incidence of cervical squamous cell carcinoma has decreased, however, the incidence of adenocarcinoma in situ (AIS) and invasive adenocarcinoma increased, predominantly in young females. The goal of this study was to evaluate the most recent incidence rates of AIS, adenocarcinoma, and squamous cell carcinoma of the uterine cervix in the Netherlands in [2004][2005][2006][2007][2008][2009][2010][2011][2012][2013]. By using Dutch national pathology and cancer registries, we calculated European standardized incidence rates ( Of these AIS cases, 58.9% had concomitant CIN and AIS with concomitant CIN showed a significantly higher EAPC compared to AIS without CIN. Our conclusion is that despite a nationwide screening program for cancer of the uterine cervix, the incidence of adenocarcinoma in the Netherlands remained stable during 2004-2013 and the incidence of adenocarcinoma in situ increased. This was most predominant in cases with concomitant CIN and in younger females. The incidence of squamous cell carcinoma decreased in the same timeframe. Cancer Medicine Open Access 417

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“…1 The replacement of conventional cytology by high-risk human papillomavirus (hrHPV) DNA testing as primary screening test in the Dutch Cervical Cancer Screening Program in 2017 will likely further increase CIN detection, given the higher sensitivity of hrHPV testing for CIN 2+ lesions. 1 The replacement of conventional cytology by high-risk human papillomavirus (hrHPV) DNA testing as primary screening test in the Dutch Cervical Cancer Screening Program in 2017 will likely further increase CIN detection, given the higher sensitivity of hrHPV testing for CIN 2+ lesions.…”

Section: Introductionmentioning

confidence: 99%

“…In the Netherlands, cervical intraepithelial neoplasia (CIN) detection rates have increased over the last decade, largely independent of the socioeconomic and demographic factors. 1 The replacement of conventional cytology by high-risk human papillomavirus (hrHPV) DNA testing as primary screening test in the Dutch Cervical Cancer Screening Program in 2017 will likely further increase CIN detection, given the higher sensitivity of hrHPV testing for CIN 2+ lesions. 2 Recent Dutch modeling estimated that the number of detected CIN lesions would increase by 196% for CIN 1 and 54% for CIN 2 over the lifetime of women entering the program in 2017 due to primary hrHPV screening.…”

Section: Introductionmentioning

confidence: 99%

Management and treatment of cervical intraepithelial neoplasia in the Netherlands after referral for colposcopy

Aitken

Siebers

Matthijsse

et al. 2019

Acta Obstet Gynecol Scand

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Introduction The aim of this study was to describe trends in the diagnosis and treatment of women referred from the national screening program with cervical intraepithelial neoplasia (CIN) in the Netherlands, and to compare these trends with national guidelines and identify potential areas for improvement for the new primary high‐risk HPV screening program. Material and methods We conducted a population‐based cohort study using data from the Dutch pathology archive. Women aged 29‐63 years who took part in the Dutch cervical screening program between 1 January 2005 and 31 December 2014 were selected. Three referral groups were identified: direct referrals and those referred after either one (first indirect referrals) or two (second indirect referrals) repeat cytology tests, totaling 85 239 referrals for colposcopy. The most invasive management technique and the most severe diagnosis of each screening episode was identified. Rates of management techniques were calculated separately by referral type, highest CIN diagnosis and age group. Results In all, 85.1% of CIN 3 lesions were treated with excision (either large excision or hysterectomy) and 26.4% of CIN 1 lesions were treated with large excision. Rates of overtreatment (CIN 1 or less) in see‐and‐treat management were higher for indirect referrals than for direct referrals and increased with age. Large excision rates increased with CIN diagnosis severity. Conclusions Despite guideline recommendations not to treat, CIN 1 lesions were treated in just over 25% of cases and approximately 15% of CIN 3 lesions were possibly undertreated. Given the expected increase in CIN detection in the new primary high‐risk HPV screening program, reduction in CIN 1 treatment and CIN 2 treatment in younger women is needed to avoid an increase in potential harm.

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Exploring the trend of increased cervical intraepithelial neoplasia detection rates in the Netherlands

Cited by 10 publications

References 15 publications

Recent increase in incidence of cervical precancerous lesions in Norway: Nationwide study from 1992 to 2016

Recent increase in incidence of cervical precancerous lesions in Norway: Nationwide study from 1992 to 2016

Increasing incidence of invasive and in situ cervical adenocarcinoma in the Netherlands during 2004–2013

Management and treatment of cervical intraepithelial neoplasia in the Netherlands after referral for colposcopy

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