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Effect of Test History at Ages 50-64 on Later Cervical Cancer Risk: A Population-based Case-control Study.

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Cervical cancer screening history in women aged 50-64 significantly impacts later cancer risk. Regular testing, even with abnormal results, reduces cervical cancer odds, emphasizing the need to consider screening history in program development.

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Area of Science:

  • Oncology
  • Public Health
  • Epidemiology

Background:

  • Increasing life expectancy necessitates re-evaluating cervical cancer screening effectiveness in older populations.
  • Previous cervical cancer screening history, including tests within and outside organized programs, may influence risk in later life.

Purpose of the Study:

  • To investigate the effect of cervical test history at ages 50-64 on the risk of developing invasive cervical cancer in women aged 65-79.
  • To assess the impact of test uptake and abnormal results on subsequent cervical cancer risk.

Main Methods:

  • A case-control study involving 229 women aged 65-79 with invasive cervical cancer (2010-2019) from the Finnish Cancer Registry.
  • Matched controls (10 per case) based on birth year and hospital district.
  • Conditional logistic regression analysis adjusted for self-selection to evaluate the effect of test history.

Main Results:

  • Test uptake between ages 50-64 was associated with a 75% lower odds of cervical cancer (aOR=0.25).
  • Untested women had 4.9 times higher odds of cervical cancer compared to those tested with normal results (aOR=4.86).
  • At least one abnormal test result increased odds by 2.5 compared to only normal results but was protective compared to untested women.

Conclusions:

  • Cervical cancer screening history is crucial for older women; testing significantly reduces cancer risk.
  • Non-attenders and those with abnormal results require special consideration in future screening program development.
  • The study highlights the importance of considering all cervical testing, not just organized programs, for assessing risk in older populations.