Cervical cancer screening
The Mass Screening Registry monitors the quality of cervical cancer screening using screening indicators, which are published for cervical cancer screening statistics each year. Current research projects of the Mass Screening Registry investigate the benefits and harms of cervical cancer screening.
PAP TESTING FOR YOUNG WOMEN:
Benefits and harms, concepts and perceptions of pap testing in Finland
Alongside the organised cervical cancer screening programme, which has been shown to be effective, there has also been a partial overlap with opportunistic sampling practices that are offered to and specifically aimed at young women. The risk of cervical cancer for young women in Finland is small and the protective effect of Pap testing for young women is therefore minor. The treatment of abnormalities that are self-healing has no practical use and can give rise to complications, unnecessary labelling of otherwise healthy young women of being sick, and it also may cause unnecessary worry. In addition to psychosocial disadvantages, opportunistic sampling additional to the standard screening programme is very expensive.
The aim of the research of the dissertation is to investigate the effect of Pap sampling within the screening programme and external to the programme on the incidence of cervical cancer in young women. A further aim is to estimate the financial cost of this prevalent activity. We specifically aim to investigate the attitudes and perceptions of Pap testing among young women and healthcare professionals by using a questionnaire-based survey. Information gained from the dissertation research will be essential when planning new modified practices and interventions to reduce the adverse effects of current practices.
The project started in the autumn of 2015. A case-control approach was used in the first original communication to evaluate the effect of Pap testing on the incidence of cervical cancer among women under the age of 40 who had undergone the Pap test. The project currently involves both the planning and implementation of surveys targeted at health care professionals, and women between the ages of 18-35.
Research plan: Tutkimussuunnitelma_nuorten_naisten_papa-testaus (pdf) (in Finnish)
Publications:
Lead researcher: Petra Makkonen
Research team: 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.
THE LIFE-TIME EFFECTIVENESS OF POPULATION-BASED AND OPPORTUNISTIC CERVICAL CANCER SCREENING
The aim of the doctoral dissertation is to investigate the effectiveness of cervical cancer screening on the incidence and mortality of cancer in the female population. In addition, the occurrence of adverse screening-related effects, such as the occurrence of false positive test results, are being examined. Important goals in developing a screening programme also include the optimisation of screening age and the evaluation of the effectiveness of opportunistic testing that occurs outside the official screening programme, which has not been sufficiently reliable to date.
The study uses the Mass Screening Registry data for screening results for the years 1991-2014 and the Cancer Registry for cancer incidence and mortality data. At a later stage of the research, nationwide data which are not currently archived by the Mass Screening Registry will also be added to the analysis. Such information will be collected from Pap tests, colposcopies and treatments of cervical precancers using data from hospital discharge registers, KELA reimbursement register, Finnish Student Health Service, and laboratories that analyse Pap samples.
The project started in 2015, after research authorisations had been obtained and when the collection of opportunistic test data commenced. The first original communication based on data from the organised screening programme was published at the beginning of 2017, and analysed the cumulative probability of abnormal screening results. The next communication also draws on data from the Mass Screening Registry and is focusing on the effectiveness of screening for women aged 65 and older. The aim is to answer the question as to whether it is worthwhile continuing nationwide screening until older ages.
Research plan: Kohdunkaulan syövän seulonnan ja sen ulkopuolisen testauksen elämänaikainen vaikuttavuus (pdf) (in Finnish)
Publications:
Effectiveness of cervical cancer screening at age 65 — A register-based cohort study
High lifetime probability of screen-detected cervical abnormalities
Lead researcher: Maiju Pankakoski
Research team: 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)