University of Twente Student Theses


Screening history of women 60 years and older diagnosed with cervical cancer in the Netherlands

Blömer, N.G.M. (2018) Screening history of women 60 years and older diagnosed with cervical cancer in the Netherlands.

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Abstract:In the Netherlands, despite a nationwide screening program since the 1980s, invasive cervical cancer has been detected in women of 60 years and older. Diagnosis of an invasive cervical cancer at the post-screening age could be a result of failure in the screening program, failure in detection or inadequate follow up of abnormalities. The aim of this study is to determine the disease occurrence of cervical cancer in relation to the screening histories of women 60 years and older at diagnosis in the Netherlands. Study design Women aged 60-84 years diagnosed with cervical cancer in the period 2010 – 2015 were selected from the Netherlands Cancer Registry (N = 787). Smear results were extracted from the Dutch nationwide network and registry of histopathology and cytopathology. Groups with different screening history were compared (Chi-square). Multivariable cox regression analysis was performed to explain possible survival differences between screening histories. Results None of the patients participated in all screening rounds, incomplete participation was reported in 39% and 61% had never been screened in the nationwide screening program. Never screened patients more often had low socioeconomic status (35% versus 22%) and advanced stage disease (76% versus 57%) than patients in the incomplete participation group. In the latter, 255 patients (83%) had 1-2 pap smears during the screening period. The interval between the abnormal last smear and date of diagnosis was < 5 years in the majority of patients (69%). No statistical significant difference in survival was found between both groups. Conclusion Women who developed cervical cancer at 60 years and older were observed with incomplete participation or were never screened in the screening program. Survival did not differ between these patient groups. However, the treatment for advanced stage disease, which was more common in the never screened group, will probably be associated with higher morbidity.
Item Type:Essay (Master)
Faculty:TNW: Science and Technology
Subject:44 medicine
Programme:Health Sciences MSc (66851)
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