What’s next? Perspectives and future needs of cervical screening in Europe in the era of molecular testing and vaccination

Lynge, Elsebeth; Antilla, Ahti; Arbyn, Marc; Segnan, Nereo; Ronco, Guglielmo

doi:10.1016/j.ejca.2009.07.024

Cited by 39 publications

(23 citation statements)

References 41 publications

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“…Their consistent and proper use is the best available means for effectively preventing sexual transmission of viral and bacterial infections ranging from HIV and HPV, an oncogenic virus, to Chlamydia and gonorrhea [1], [2], [3]. Studies on condom use are often limited to specific subgroups such as students, sex workers or abortion seekers.…”

Section: Introductionmentioning

confidence: 99%

Assessing Perceived Risk and STI Prevention Behavior: A National Population-Based Study with Special Reference to HPV

et al. 2011

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IntroductionTo better understand trends in sexually transmitted infection (STI) prevention, specifically low prevalence of condom use with temporary partners, the aim of this study was to examine factors associated with condom use and perceptions of STI risk amongst individuals at risk, with the underlying assumption that STI risk perceptions and STI prevention behaviors are correlated.MethodsA national population-based survey on human papillomavirus (HPV) and sexual habits of young adults aged 18–30 was conducted in Sweden in 2007, with 1712 men and 8855 women participating. Regression analyses stratified by gender were performed to measure condom use with temporary partners and STI risk perception.ResultsMen's condom use was not associated with STI risk perception while women's was. Awareness of and disease severity perceptions were not associated with either condom use or risk perception though education level correlated with condom use. Women's young age at sexual debut was associated with a higher risk of non-condom use later in life (OR 1.95 95% CI: 1.46–2.60). Women with immigrant mothers were less likely to report seldom/never use of condoms with temporary partners compared to women with Swedish-born mothers (OR 0.53 95% CI: 0.37–0.77). Correlates to STI risk perception differ substantially between sexes. Number of reported temporary partners was the only factor associated for both men and women with condom use and STI risk perception.ConclusionsPublic health interventions advocating condom use with new partners could consider employing tactics besides those which primarily aim to increase knowledge or self-perceived risk if they are to be more effective in STI reduction. Gender-specific prevention strategies could be effective considering the differences found in this study.

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Section: Introductionmentioning

confidence: 99%

Assessing Perceived Risk and STI Prevention Behavior: A National Population-Based Study with Special Reference to HPV

et al. 2011

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“…Worldwide, the Pap test is still used by the majority of cervical cancer screening programs as the primary laboratorial tool of prevention. The conventional Pap smear has a winning history on decreasing the incidence of and mortality from cervical cancer, with an estimated reduction of around 80%, but this is restricted to settings with high-quality cytology screening that is effectively and regularly executed, with a good population coverage [4]. The conventional Pap smear, however, is quite laborious, with various difficulties concerning collection, the preparation of glass slides and reading.…”

Section: Introductionmentioning

confidence: 99%

Critical Analyses of the Introduction of Liquid-Based Cytology in a Public Health Service of the State of São Paulo, Brazil

et al. 2015

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Objective: The aim of this study was to compare the performance of the current conventional Pap smear with liquid-based cytology (LBC) preparations. Study Design: Women routinely undergoing their cytopathological and histopathological examinations at Fundação Oncocentro de São Paulo (FOSP) were recruited for LBC. Conventional smears were analyzed from women from other areas of the State of São Paulo with similar sociodemographic characteristics. Results: A total of 218,594 cases were analyzed, consisting of 206,999 conventional smears and 11,595 LBC. Among the conventional smears, 3.0% were of unsatisfactory preparation; conversely, unsatisfactory LBC preparations accounted for 0.3%. The ASC-H (atypical squamous cells - cannot exclude high-grade squamous intraepithelial lesion) frequency did not demonstrate any differences between the two methods. In contrast, the incidence of ASC-US (atypical squamous cells of undetermined significance) was almost twice as frequent between LBC and conventional smears, at 2.9 versus 1.6%, respectively. An equal percentage of high-grade squamous intraepithelial lesions were observed for the two methods, but not for low-grade squamous intraepithelial lesions, which were more significantly observed in LBC preparations than in conventional smears (2.2 vs. 0.7%). The index of positivity was importantly enhanced from 3.0% (conventional smears) to 5.7% (LBC). Conclusions: LBC performed better than conventional smears, and we are truly confident that LBC can improve public health strategies aimed at reducing cervical lesions through prevention programs.

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“…For example, secondary prevention with screening for cervical cancer in asymptomatic females is quite successful [2], while the effect of secondary prevention of prostate cancer remains debated [3]. With the current lack of disease-modifying AD therapy, few strong arguments favour early AD diagnosis in clinical routine, although this could change within a foreseeable future.…”

Section: Introductionmentioning

confidence: 99%

To Know or Not to Know: Ethical Issues Related to Early Diagnosis of Alzheimer's Disease

Mattsson

Brax

Zetterberg

2010

International Journal of Alzheimer's Disease

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In Alzheimer's disease (AD), pathological processes start in the brain long before clinical dementia. Biomarkers reflecting brain alterations may therefore indicate disease at an early stage, enabling early diagnosis. This raises several ethical questions and the potential benefits of early diagnosis must be weighted against possible disadvantages. Currently, there are few strong arguments favouring early diagnosis, due to the lack of disease modifying therapy. Also, available diagnostic methods risk erroneous classifications, with potentially grave consequences. However, a possible benefit of early diagnosis even without disease modifying therapy is that it may enable early decision making when patients still have full decision competence, avoiding problems of hypothetical consents. It may also help identifying patients with cognitive dysfunction secondary to other diseases that may be responsive to treatment already today.

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What’s next? Perspectives and future needs of cervical screening in Europe in the era of molecular testing and vaccination

Cited by 39 publications

References 41 publications

Assessing Perceived Risk and STI Prevention Behavior: A National Population-Based Study with Special Reference to HPV

Assessing Perceived Risk and STI Prevention Behavior: A National Population-Based Study with Special Reference to HPV

Critical Analyses of the Introduction of Liquid-Based Cytology in a Public Health Service of the State of São Paulo, Brazil

To Know or Not to Know: Ethical Issues Related to Early Diagnosis of Alzheimer's Disease

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