Expanding the upper age limit for cervical cancer screening: a protocol for a nationwide non-randomised intervention study
Introduction Cervical cancer screening ceases between the ages of 60 and 65 in most countries. Yet, a relatively high proportion of cervical cancers are diagnosed in women above the screening age. This study will evaluate if screening of women aged 65–69 years may result in increased detection of ce...
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BMJ Publishing Group
2020-11-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/10/11/e039636.full |
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| author | Anne Hammer Berit Andersen Jørgen Skov Jensen Mette Tranberg Lone Kjeld Petersen Klara Miriam Elfström Jan Blaakær Mary Holten Bennetsen |
| author_facet | Anne Hammer Berit Andersen Jørgen Skov Jensen Mette Tranberg Lone Kjeld Petersen Klara Miriam Elfström Jan Blaakær Mary Holten Bennetsen |
| author_sort | Anne Hammer |
| collection | DOAJ |
| description | Introduction Cervical cancer screening ceases between the ages of 60 and 65 in most countries. Yet, a relatively high proportion of cervical cancers are diagnosed in women above the screening age. This study will evaluate if screening of women aged 65–69 years may result in increased detection of cervical intraepithelial neoplasia grade 2 or worse (CIN2+) compared with women not invited to screening. Invited women may choose between general practitioner (GP)-based screening or cervico-vaginal self-sampling. Furthermore, the study will assess if self-sampling is superior to GP-based screening in reaching long-term unscreened women.Methods and analysis This population-based non-randomised intervention study will include 10 000 women aged 65–69 years, with no record of a cervical cytology sample or screening invitation in the 5 years before inclusion. Women who have opted-out of the screening programme or have a record of hysterectomy or cervical amputation are excluded. Women residing in the Central Denmark Region (CDR) are allocated to the intervention group, while women residing in the remaining four Danish regions are allocated to the reference group. The intervention group is invited for human papillomavirus-based screening by attending routine screening at the GP or by requesting a self-sampling kit. The reference group receives standard care which is the opportunity to have a cervical cytology sample obtained at the GP or by a gynaecologist. The study started in April 2019 and will run over the next 4.5 years. The primary outcome will be the proportion of CIN2+ detected in the intervention and reference groups. In the intervention group, the proportion of long-term unscreened women attending GP-based screening or self-sampling will be compared.Ethics and dissemination The study has been submitted to the Ethical Committee in the CDR which deemed that the study was not notifiable to the Committee and informed consent is therefore not required. The study is approved by the Danish Data Protection Regulation and the Danish Patient Safety Authority. Results will be disseminated in peer-reviewed journals.Trial registration number NCT04114968. |
| format | Article |
| id | doaj-art-f2b6445e33924f8081f84e4b29a6e7b0 |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2020-11-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-f2b6445e33924f8081f84e4b29a6e7b02024-11-27T06:55:10ZengBMJ Publishing GroupBMJ Open2044-60552020-11-01101110.1136/bmjopen-2020-039636Expanding the upper age limit for cervical cancer screening: a protocol for a nationwide non-randomised intervention studyAnne Hammer0Berit Andersen1Jørgen Skov Jensen2Mette Tranberg3Lone Kjeld Petersen4Klara Miriam Elfström5Jan Blaakær6Mary Holten Bennetsen7Department of Clinical Medicine, Aarhus University, Aarhus, DenmarkUniversity Research Clinic for Cancer Screening, Randers Regional Hospital, Randers, DenmarkStatens Serum Institut, Copenhagen, DenmarkDepartment of Public Health Programmes, Randers Regional Hospital, Randers, DenmarkDepartment of Gynecology and Obstetrics, Odense University, Odense, DenmarkDepartment of Laboratory Medicine, Karolinska Institutet, Stockholm, SwedenDepartment of Clinical Research, University of Southern Denmark, Odense, DenmarkDepartment of Pathology, Regional Hospital Randers, Randers, DenmarkIntroduction Cervical cancer screening ceases between the ages of 60 and 65 in most countries. Yet, a relatively high proportion of cervical cancers are diagnosed in women above the screening age. This study will evaluate if screening of women aged 65–69 years may result in increased detection of cervical intraepithelial neoplasia grade 2 or worse (CIN2+) compared with women not invited to screening. Invited women may choose between general practitioner (GP)-based screening or cervico-vaginal self-sampling. Furthermore, the study will assess if self-sampling is superior to GP-based screening in reaching long-term unscreened women.Methods and analysis This population-based non-randomised intervention study will include 10 000 women aged 65–69 years, with no record of a cervical cytology sample or screening invitation in the 5 years before inclusion. Women who have opted-out of the screening programme or have a record of hysterectomy or cervical amputation are excluded. Women residing in the Central Denmark Region (CDR) are allocated to the intervention group, while women residing in the remaining four Danish regions are allocated to the reference group. The intervention group is invited for human papillomavirus-based screening by attending routine screening at the GP or by requesting a self-sampling kit. The reference group receives standard care which is the opportunity to have a cervical cytology sample obtained at the GP or by a gynaecologist. The study started in April 2019 and will run over the next 4.5 years. The primary outcome will be the proportion of CIN2+ detected in the intervention and reference groups. In the intervention group, the proportion of long-term unscreened women attending GP-based screening or self-sampling will be compared.Ethics and dissemination The study has been submitted to the Ethical Committee in the CDR which deemed that the study was not notifiable to the Committee and informed consent is therefore not required. The study is approved by the Danish Data Protection Regulation and the Danish Patient Safety Authority. Results will be disseminated in peer-reviewed journals.Trial registration number NCT04114968.https://bmjopen.bmj.com/content/10/11/e039636.full |
| spellingShingle | Anne Hammer Berit Andersen Jørgen Skov Jensen Mette Tranberg Lone Kjeld Petersen Klara Miriam Elfström Jan Blaakær Mary Holten Bennetsen Expanding the upper age limit for cervical cancer screening: a protocol for a nationwide non-randomised intervention study BMJ Open |
| title | Expanding the upper age limit for cervical cancer screening: a protocol for a nationwide non-randomised intervention study |
| title_full | Expanding the upper age limit for cervical cancer screening: a protocol for a nationwide non-randomised intervention study |
| title_fullStr | Expanding the upper age limit for cervical cancer screening: a protocol for a nationwide non-randomised intervention study |
| title_full_unstemmed | Expanding the upper age limit for cervical cancer screening: a protocol for a nationwide non-randomised intervention study |
| title_short | Expanding the upper age limit for cervical cancer screening: a protocol for a nationwide non-randomised intervention study |
| title_sort | expanding the upper age limit for cervical cancer screening a protocol for a nationwide non randomised intervention study |
| url | https://bmjopen.bmj.com/content/10/11/e039636.full |
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