Evidence map›Paper›PMID 30944091›Full record

ArticleBMJ (Clinical research ed.)2019

Cervical screening and risk of adenosquamous and rare histological types of invasive cervical carcinoma: population based nested case-control study.

Jiayao Lei, Bengt Andrae, Alexander Ploner, Camilla Lagheden, Carina Eklund, Sara Nordqvist Kleppe, Jiangrong Wang, Fang Fang, Joakim Dillner, K Miriam Elfström and 1 more

Abstract read
In one paragraph

Article in BMJ (Clinical research ed.), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.

0numbers the graph read from it
0cells of the map it votes in
21citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

21 citing papers in PubMed.

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  13. Ultrasonographic diagnosis in rare primary cervical cancer.International journal of gynecological cancer : official journal of the International Gynecological Cancer Society · 2021
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Jiayao LeiDepartment of Medical Epidemiology and Biostatistics, Karolinska Institutet, 171 77 Stockholm, Sweden.ORCID https://orcid.org/0000-0002-4718-1414
Bengt AndraeDepartment of Medical Epidemiology and Biostatistics, Karolinska Institutet, 171 77 Stockholm, Sweden.
Alexander PlonerDepartment of Medical Epidemiology and Biostatistics, Karolinska Institutet, 171 77 Stockholm, Sweden.
Camilla LaghedenDepartment of Laboratory Medicine, Karolinska Institutet, 141 83 Stockholm, Sweden.
Carina EklundDepartment of Laboratory Medicine, Karolinska Institutet, 141 83 Stockholm, Sweden.
Sara Nordqvist KleppeDepartment of Medical Epidemiology and Biostatistics, Karolinska Institutet, 171 77 Stockholm, Sweden.
Jiangrong WangDepartment of Medical Epidemiology and Biostatistics, Karolinska Institutet, 171 77 Stockholm, Sweden.
Fang FangDepartment of Medical Epidemiology and Biostatistics, Karolinska Institutet, 171 77 Stockholm, Sweden.
Joakim DillnerDepartment of Laboratory Medicine, Karolinska Institutet, 141 83 Stockholm, Sweden.
K Miriam ElfströmDepartment of Laboratory Medicine, Karolinska Institutet, 141 83 Stockholm, Sweden.
Pär SparénDepartment of Medical Epidemiology and Biostatistics, Karolinska Institutet, 171 77 Stockholm, Sweden.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo examine the association of cervical cytology screening with the risk of adenosquamous cell carcinoma (ASC) and rare histological types of invasive cervical carcinoma (RICC), using comprehensive registry data, and to assess tumour human papillomavirus status of ASC and RICC.

designNationwide, population based, nested case-control study.

settingSweden.

participantsAll cases of invasive cervical carcinoma in Sweden during 2002-11 (4254 confirmed cases after clinical and histopathological review). 338 cases were neither squamous cell carcinoma nor adenocarcinoma, including 164 cases of ASC and 174 cases of RICC (glassy cell carcinoma, clear cell carcinoma, small cell carcinoma, neuroendocrine cell carcinoma, large cell carcinoma, and undifferentiated carcinoma). 30 birth year matched controls from the general Swedish population were matched to each case by applying incidence density sampling.

main outcome measuresConditional logistic regression was used to calculate odds ratios, interpreted as incidence rate ratios, for risk of ASC and RICC in relation to screening status and screening history, adjusted for education. Human papillomavirus distribution of ASC and RICC was based on available archival tumour tissues from most Swedish pathology biobanks.

resultsWomen with two screening tests in the previous two recommended screening intervals had a lower risk of ASC (incidence rate ratio 0.22, 95% confidence interval 0.14 to 0.34) and RICC (0.34, 0.21 to 0.55), compared with women without any test. High risk human papillomavirus was detected in 148/211 (70%) cases with valid human papillomavirus results from tumour tissues. The risk reduction among women with tumours that were positive (incidence rate ratio 0.28, 0.18 to 0.46) and negative (0.27, 0.13 to 0.59) for high risk human papillomavirus was similar, compared with women who did not attend any test.

conclusionsCervical screening is associated with reduced risk of ASC and RICC, and most ASC and RICC are positive for high risk human papillomavirus. This evidence provides a benchmark for evaluating future cervical screening strategies.

Indexed as

Early Detection of CancerAdultAgedCarcinoma, AdenosquamousCarcinoma, Squamous CellCase-Control StudiesCervix UteriFemaleHumansIncidenceMiddle AgedPapillomavirus InfectionsRegistriesRiskRisk Reduction BehaviorUterine Cervical Neoplasms

Identifiers

PMID30944091
PMCPMC6446178

What OpenQuestion holds

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LicenceCC BY-NC
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.