Screening participation after a false positive result in organized cervical cancer screening: a nationwide register-based cohort study

Abstract

Our aim was to investigate whether receiving a false positive (FP) cervical cytology result affected subsequent cervical cancer screening participation. This Danish nationwide register-based cohort study included 502,380 women aged 22.5–45 attending cervical cancer screening in 2012–2014 with a normal (n = 501,003) or FP (n = 1,377) cytology screening result. A FP result was defined as a cervical cytology showing high grade cytological abnormalities followed by a normal or ‘Cervical Intraepithelial Neoplasia grade 1’ biopsy result. Women were categorized as subsequent participants if they had a cervical cytology within 24–42 months after their last screening or surveillance test. We compared subsequent participation among women with a normal versus a FP result, using odds ratios including 95% confidence intervals. Participation was slightly higher among women with FP results than among women with normal results (71.5% vs. 69.2%, p = 0.058). After adjustment for age and screening history, women with FP results participated significantly more than women with normal results (OR: 1.19, 95% CI 1.06–1.35). Women receiving a FP result did not participate less in subsequent cervical cancer screening than women receiving a normal result. In fact, the use of opportunistic screening seemed to be increased among women receiving a FP result.

Development of a Nomogram Predicting the Risk of Persistence/Recurrence of Cervical Dysplasia

“…Assessing the risk of cervical dysplasia persistence/recurrence is of paramount importance. The importance of our findings might be explained by three main reasons: (i) our analysis provides a clear method to improve appropriate counseling of patients undergoing conization; (ii) a better understanding of 5-year risk assessment is crucial to tailoring appropriate follow-up schedules, especially in settings with limited resources; and (iii) by applying this nomogram, general practitioners can triage high-risk patients in specialized centers, thus reducing the number of misdiagnoses and improving the quality of care [14,15].…”

Primary and Triage Cervical Screening Diagnostic Value of Methods for the Detection of Cervical Dysplasia

“…The reason could be that there was a high number of true-positive cases obtained when CIN+ samples were applied in confirmation unlike when ASCUS and CIN+ were combined. Latent and initial stages of HPV infection often have a low incidence of cervical neoplasia and a higher chance of false-negativity as the viral load is too low to be detected using HPV-PCR [ 28 ].…”