Cervical cancer screening

The Mass Screening Registry monitors the quality of cervical cancer screening using screening indicators published each year in cervical cancer screening statistics. The research projects of the Mass Screening Registry investigate the benefits and downsides of cervical cancer screening.

PAP TESTING FOR YOUNG WOMEN:

advantages, disadvantages and notions and perceptions of them in Finland

Alongside the organised cancer screening programme for cervical cancer, which has shown to be effective, there has been a partial overlap of sampling practices outside the programme aimed especially for young women. The risk of cervical cancer for young women is ​​small and the protective effect of Pap testing is minor. The treatment of cellular changes that are self-healing is useless and can give rise to complications as well as the unnecessary labelling of being sick, and worry. In addition to psychosocial disadvantages, opportunistic sampling outside the screening programme is very expensive.
The aim of the dissertation research is to investigate the effect of Pap sampling within the screening programme and outside it on cervical cancer incidence in young women, and to estimate the financial cost of this prevalent activity. In addition, using a questionnaire study we aim to find out the attitudes and perceptions of Pap testing among young women and nursing staff. Information gained from the dissertation research will be essential when planning renewed practices and interventions to reduce the adverse effects of current practices.
The project started in autumn 2015. In the first original communication, a case-control approach was used to evaluate the effect of Pap testing on the incidence of cervical cancer among women under the age of 40 who have had the Pap test. The project currently involves both planning and implementation of surveys targeted at health care professionals, and women betweeb the ages of 18-35.

Research team: Petra Makkonen, Ahti Anttila, Sirpa Heinävaara, Tytti Sarkeala, and Anni Virtanen, and for the questionnaire study Pekka Nieminen and Nanna Sarvilinna

Funding: Cancer Society of Finland, Cancer Foundation of Finland

Collaborating institutions: The questionnaire study will be carried out in cooperation with the cities of Espoo, Helsinki, Kuopio, Oulu and Vantaa, the Finnish Student Health Service, Laboatory HUSLAB, and the university hospitals of Helsinki, Kuopio and Oulu.

Lead researcher: Petra Makkonen

THE LIFE-TIME EFFECTIVENESS OF CERVICAL CANCER SCREENING AND ITS EXTERNAL TESTING

The purpose of the doctoral dissertation is to investigate the effectiveness of cervical cancer screening on the incidence of cancer and the mortality due to the disease in the female population. In addition, screening adverse effects, such as the occurrence of false positive test results, will be examined. Important goals for developing a screening program also include the optimisation of screening age and the evaluation of the effectiveness of testing outside the screening program, which has not been sufficiently reliable to date.

The study uses Mas Screening Registry data for screening results for the years 1991-2014 and the Cancer Registry for cancer and mortality data. At a later stage, nationwide data from outside the organisation of mass screening will also be added to the evidence. Information will be collected from Pap tests, cervical cancer endoscopy (colposcopy) and cervical cancer preoperative therapies, and the sources used are hospital discharge registers, KELA reimbursement data, Finnish Student Health Service data, and data from laboratories analysing Pap samples.

The project started in 2015, when research authorisations were obtained and the collection of non-screening test data was started. The first original communication based on screening inventory material was completed at the beginning of 2017, and discussed the cumulative prevalence of abnormal screening results. The next communication also draws on data from the Mass Screening Registry to focus on the effectiveness of screening for women aged 65 and above, and seeks to answer the question of whether it is worthwhile to continuing screening throughout the country.

Publications: High lifetime probability of screen-detected cervical abnormalities

Research team: Maiju Pankakoski, Sirpa Heinävaara, Ahti Anttila, Tytti Sarkeala

Funding: Cancer Society of Finland, Cancer Foundation of Finland

Content / description of research project:

Collaborating institutions: University of Helsinki / Doctoral Programme in Population Helath (DocPop)

Lead researcher: Maiju Pankakoski