Impact of opportunistic screening on squamous cell and adenocarcinoma of the cervix in Germany: A population-based case-control study.

<h4>Background</h4>We investigated the uptake of opportunistic cervical cancer screening (CCS) and other risk factors and their association with cervical cancer in Germany in a case-control study.<h4>Methods and findings</h4>We recruited incident cases of cervical cancer (ICD...

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Autores principales:	Luana F Tanaka, Dirk Schriefer, Kathrin Radde, Gunther Schauberger, Stefanie J Klug
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/dd8c6fa894154c4ca1232e0d78c98ea3
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spelling	oai:doaj.org-article:dd8c6fa894154c4ca1232e0d78c98ea32021-12-02T20:15:22ZImpact of opportunistic screening on squamous cell and adenocarcinoma of the cervix in Germany: A population-based case-control study.1932-620310.1371/journal.pone.0253801https://doaj.org/article/dd8c6fa894154c4ca1232e0d78c98ea32021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0253801https://doaj.org/toc/1932-6203<h4>Background</h4>We investigated the uptake of opportunistic cervical cancer screening (CCS) and other risk factors and their association with cervical cancer in Germany in a case-control study.<h4>Methods and findings</h4>We recruited incident cases of cervical cancer (ICD-10 C53) diagnosed between 2012 and 2016 and matched with three population-based controls, based on age and region of residence. Cases and controls reported their CCS participation during the past ten years (frequent: every three years; no or infrequent: less than every three years) and other relevant variables. We fitted conditional logistic regression models, reporting odds ratios (OR) and 95% confidence intervals (95% CI). We report overall and stratified analyses by histologic group (squamous cell-SCC, and adenocarcinoma-AC), T category (T1 and T2+), and age (<50 and ≥50 years). We analysed 217 cases and 652 matched controls. 53.0% of cases and 85.7% of controls attended CCS frequently. In the overall adjusted model, no or infrequent participation in CCS (OR 5.63; 95% CI 3.51 to 9.04), having had more than one sexual partner (OR 2.86; 95%CI 1.50 to 5.45) and obesity (OR 1.69; 95% CI 1.01 to 2.83) were associated with cervical cancer. Twelve years of schooling (OR 0.37; 95% CI 0.23 to 0.60) and a net monthly income of €3000 or more (OR 0.50; 95% CI 0.30 to 0.82) were protective factors. In the stratified analyses, no or infrequent participation was associated with T1 (OR 4.37; 95% CI 2.48 to 7.71), T2+ (OR 10.67; 95% CI 3.83 to 29.74), SCC (OR 6.88; 95% CI 4.08 to 11.59) and AC (OR 3.95; 95% CI 1.47 to 10.63).<h4>Conclusion</h4>Although women who frequently attended CCS were less likely to develop cervical cancer, especially larger tumours, the high proportion of cases who had been frequently screened prior to diagnosis underscores the need to investigate the quality of cytology and treatment of precancerous lesions in Germany.Luana F TanakaDirk SchrieferKathrin RaddeGunther SchaubergerStefanie J KlugPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 7, p e0253801 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Luana F Tanaka Dirk Schriefer Kathrin Radde Gunther Schauberger Stefanie J Klug Impact of opportunistic screening on squamous cell and adenocarcinoma of the cervix in Germany: A population-based case-control study.
description	<h4>Background</h4>We investigated the uptake of opportunistic cervical cancer screening (CCS) and other risk factors and their association with cervical cancer in Germany in a case-control study.<h4>Methods and findings</h4>We recruited incident cases of cervical cancer (ICD-10 C53) diagnosed between 2012 and 2016 and matched with three population-based controls, based on age and region of residence. Cases and controls reported their CCS participation during the past ten years (frequent: every three years; no or infrequent: less than every three years) and other relevant variables. We fitted conditional logistic regression models, reporting odds ratios (OR) and 95% confidence intervals (95% CI). We report overall and stratified analyses by histologic group (squamous cell-SCC, and adenocarcinoma-AC), T category (T1 and T2+), and age (<50 and ≥50 years). We analysed 217 cases and 652 matched controls. 53.0% of cases and 85.7% of controls attended CCS frequently. In the overall adjusted model, no or infrequent participation in CCS (OR 5.63; 95% CI 3.51 to 9.04), having had more than one sexual partner (OR 2.86; 95%CI 1.50 to 5.45) and obesity (OR 1.69; 95% CI 1.01 to 2.83) were associated with cervical cancer. Twelve years of schooling (OR 0.37; 95% CI 0.23 to 0.60) and a net monthly income of €3000 or more (OR 0.50; 95% CI 0.30 to 0.82) were protective factors. In the stratified analyses, no or infrequent participation was associated with T1 (OR 4.37; 95% CI 2.48 to 7.71), T2+ (OR 10.67; 95% CI 3.83 to 29.74), SCC (OR 6.88; 95% CI 4.08 to 11.59) and AC (OR 3.95; 95% CI 1.47 to 10.63).<h4>Conclusion</h4>Although women who frequently attended CCS were less likely to develop cervical cancer, especially larger tumours, the high proportion of cases who had been frequently screened prior to diagnosis underscores the need to investigate the quality of cytology and treatment of precancerous lesions in Germany.
format	article
author	Luana F Tanaka Dirk Schriefer Kathrin Radde Gunther Schauberger Stefanie J Klug
author_facet	Luana F Tanaka Dirk Schriefer Kathrin Radde Gunther Schauberger Stefanie J Klug
author_sort	Luana F Tanaka
title	Impact of opportunistic screening on squamous cell and adenocarcinoma of the cervix in Germany: A population-based case-control study.
title_short	Impact of opportunistic screening on squamous cell and adenocarcinoma of the cervix in Germany: A population-based case-control study.
title_full	Impact of opportunistic screening on squamous cell and adenocarcinoma of the cervix in Germany: A population-based case-control study.
title_fullStr	Impact of opportunistic screening on squamous cell and adenocarcinoma of the cervix in Germany: A population-based case-control study.
title_full_unstemmed	Impact of opportunistic screening on squamous cell and adenocarcinoma of the cervix in Germany: A population-based case-control study.
title_sort	impact of opportunistic screening on squamous cell and adenocarcinoma of the cervix in germany: a population-based case-control study.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/dd8c6fa894154c4ca1232e0d78c98ea3
work_keys_str_mv	AT luanaftanaka impactofopportunisticscreeningonsquamouscellandadenocarcinomaofthecervixingermanyapopulationbasedcasecontrolstudy AT dirkschriefer impactofopportunisticscreeningonsquamouscellandadenocarcinomaofthecervixingermanyapopulationbasedcasecontrolstudy AT kathrinradde impactofopportunisticscreeningonsquamouscellandadenocarcinomaofthecervixingermanyapopulationbasedcasecontrolstudy AT guntherschauberger impactofopportunisticscreeningonsquamouscellandadenocarcinomaofthecervixingermanyapopulationbasedcasecontrolstudy AT stefaniejklug impactofopportunisticscreeningonsquamouscellandadenocarcinomaofthecervixingermanyapopulationbasedcasecontrolstudy
_version_	1718374614477832192

Impact of opportunistic screening on squamous cell and adenocarcinoma of the cervix in Germany: A population-based case-control study.

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