The goal of this observational study is to assess the five-year incidence of histologically confirmed cervical cancer among women who test positive for human papillomavirus (HPV) with low-grade cytological abnormalities, to evaluate whether follow-up intensity could be reduced in women participating in the Dutch population-based cervical cancer screening program who are HPV-positive and have low-grade cytological abnormalities - atypical squamous cells of undetermined significance (ASC-US), atypical glandular cells of endocervical origin (AGC), or low-grade squamous intraepithelial lesions (LSIL). The main questions it aims to answer are: What is the five-year risk of developing cervical cancer in HPV-positive women with low-grade cytological abnormalities? Does the presence of subsequent low-grade cytology affect the five-year risk of cervical cancer in this population? Researchers will compare the risk of cervical cancer in HPV-positive women with low-grade abnormalities to women with stable negative for intraepithelial lesion or malignancy (NILM) cytology, since women with stable NILM are discharged from further follow-up back to the screening programme. This will help evaluate whether follow-up intensity can be reduced in women with low-grade abnormalities.
Study Type
OBSERVATIONAL
Enrollment
46,079
Five-year incidence cervical cancer
Incidence of histologically confirmed cervical cancer within the five-year screening interval.
Time frame: From enrollment up to 5 years after.
Time to diagnosis of cervical carcinoma
Time from enrollment to diagnosis of cervical carcinoma
Time frame: From enrollment up to 5 years after.
All-cause mortality
The number of participants that died from enrollment up to five years after, all causes of death included.
Time frame: From enrollment up to 5 years after.
Examination at which the diagnosis cervical carcinoma was established
Type of examination at which the diagnosis was established
Time frame: Moment of diagnosis of cervical carcinoma from enrollment up to 5 years after.
Carcinoma subtype
Histological characteristics of carcinoma (subtype).
Time frame: Moment of diagnosis of cervical carcinoma within 5 years after enrollment.
Incidence of cervical cancer within 5 years of inclusion stratified by histological diagnosis within three months of enrollment
Incidence of cervical cancer within 5 years of inclusion stratified by histological diagnosis within three months of baseline abnormal cytology (≤ CIN I vs CIN 2+) and, for the ≤ CIN I group, fur-ther stratified by cytology at 12-month follow-up (no or nondiagnostic cytology, ≤ LSIL, HSIL +).
Time frame: From enrollment up to 5 years after.
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