Incidence of cervical cancer after several negative smear results by age 50: prospective observational study

Matejka Rebolj, Marjolein van Ballegooijen, Elsebeth Lynge, Caspar Looman, Marie-Louise Essink-Bot, Rob Boer, Dik Habbema

Research output: Contribution to journalArticlepeer-review

31 Citations (Scopus)

Abstract

OBJECTIVE: To determine the incidence of cervical cancer after several negative cervical smear tests at different ages.

DESIGN: Prospective observational study of incidence of cervical cancer after the third consecutive negative result based on individual level data in a national registry of histopathology and cytopathology (PALGA).

SETTING: Netherlands, national data. Population 218,847 women aged 45-54 and 445,382 aged 30-44 at the time of the third negative smear test.

MAIN OUTCOME MEASURES: 10 year cumulative incidence of interval cervical cancer.

RESULTS: 105 women developed cervical cancer within 2 595,964 woman years at risk after the third negative result at age 30-44 and 42 within 1,278,532 woman years at risk after age 45-54. During follow-up, both age groups had similar levels of screening. After 10 years of follow-up, the cumulative incidence rate of cervical cancer was similar: 41/100,000 (95% confidence interval 33 to 51) in the younger group and 36/100,000 (24 to 52) in the older group (P=0.48). The cumulative incidence rate of cervical intraepithelial neoplasia grade I+ was twice as high in the younger than in the older group (P<0.001).

CONCLUSIONS: The risk for cervical cancer after several negative smear results by age 50 is similar to the risk at younger ages. Even after several negative smear results, age is not a good discriminative factor for early cessation of cervical cancer screening.

Original languageEnglish
Pages (from-to)b1354
JournalBMJ (Online)
Volume338
DOIs
Publication statusPublished - 24 Apr 2009

Keywords

  • Adult
  • Age Distribution
  • Aged
  • Female
  • Humans
  • Incidence
  • Mass Screening/methods
  • Middle Aged
  • Netherlands/epidemiology
  • Prospective Studies
  • Risk Factors
  • Uterine Cervical Neoplasms/epidemiology
  • Vaginal Smears

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