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Invasive cervical cancer detection after transition to primary human papillomavirus screening

2026-08-03Artigo científico Acesso aberto
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dc.contributor.authorSousa, Rita
dc.contributor.authorFonseca-Moutinho, José Alberto
dc.contributor.authorGomes, Fábio
dc.contributor.authorLoureiro, Fernanda
dc.contributor.authorNascimento, Helena
dc.contributor.authorSolheiro, Helena
dc.contributor.authorSaavedra, Isabel
dc.contributor.authorPonte, Madalena
dc.contributor.authorBarros, Mónica
dc.contributor.authorPereira, Sofia
dc.contributor.authorRebelo, Teresa
dc.contributor.authorCaeiro, Vítor
dc.contributor.authorGoes, Ana Rita
dc.contributor.authorSoares, Patrícia
dc.contributor.institutionLaboratório Associado de Translacção e Inovação para a Saúde Global - LA Real (Pólo ENSP)
dc.contributor.institutionComprehensive Health Research Centre (CHRC) - Pólo ENSP
dc.contributor.institutionCentro de Investigação em Saúde Pública (CISP/PHRC)
dc.contributor.institutionEscola Nacional de Saúde Pública (ENSP)
dc.contributor.pblBiblioteca Nacional de Portugal, Centro de Estudos Históricos, CELOM
dc.date.accessioned2026-08-31T14:15:01Z
dc.date.available2026-08-31T14:15:01Z
dc.date.issued2026-08-03
dc.descriptionPublisher Copyright: Copyright © Ordem dos Médicos 2026
dc.description.abstractIntroduction: Invasive cervical cancer (ICC) is a key outcome for evaluating cervical cancer screening (CCS) programs. Monitoring ICC trends and distinguishing cancers detected within and outside the organized screening program are essential for assessing program impact, particularly during transitions such as the introduction of human papillomavirus (HPV) based primary screening. Methods: We conducted a retrospective population-based study in Portugal's Central Region (2014 - 2023). Deterministic linkage was performed between the organized CCS database and hospital morbidity records. Invasive cervical cancer cases were classified as screen-detected or non-screen-detected based on prior screening history. Incidence rates were calculated using population denominators. Poisson regression models with log link and log-transformed population offsets were fitted to estimate incidence rate ratios (IRR) comparing cytology-based (2014 - 2019) and HPV-based (2020 - 2023) periods, adjusting for temporal trends. Results: A total of 654 ICC cases were included. Screening participation remained broadly stable over time. The HPV-based period was associated with a significantly higher rate of screen-detected ICC (IRR = 1.94; 95% CI 1.11 - 3.40) compared with the cytology period. In contrast, ICC incidence outside the organized screening program did not differ significantly between periods (IRR = 0.94; 95% CI 0.65 - 1.35). Conclusion: The transition to HPV-based primary screening was associated with a shift in ICC detection towards the organized screening program, without evidence of a corresponding increase in incidence among women diagnosed outside the organized screening program. These findings should, however, be interpreted with caution in light of the early phase of implementation and potential external factors influencing access to diagnosis. Overall, the results support a shift in detection within the screening pathway rather than changes in underlying disease occurrence. Strengthening integration between screening, hospital, and cancer registry data remains essential for robust evaluation of cervical cancer screening policies.en
dc.description.versionpublishersversion
dc.description.versionpublished
dc.format.extent10
dc.format.extent981510
dc.identifier.doi10.20344/amp.24709
dc.identifier.issn0870-399X
dc.identifier.otherPURE: 171930619
dc.identifier.otherPURE UUID: 0502ce60-87b7-496e-b431-5cd1092ded6d
dc.identifier.otherScopus: 105046263191
dc.identifier.otherPubMed: 42556424
dc.identifier.otherWOS: 001841151700003
dc.identifier.urihttp://hdl.handle.net/10362/205876
dc.identifier.urlhttps://www.scopus.com/pages/publications/105046263191
dc.language.isomul
dc.peerreviewedyes
dc.subjectEarly Detection of Cancer
dc.subjectMedical Record Linkage
dc.subjectPapillomaviridae
dc.subjectPapillomavirus Infections/diagnosis
dc.subjectUterine Cervical Dysplasia/diagnosis
dc.subjectUterine Cervical Neoplasms/diagnosis
dc.subjectGeneral Medicine
dc.subjectSDG 3 - Good Health and Well-being
dc.titleInvasive cervical cancer detection after transition to primary human papillomavirus screening
dc.title.alternativeDeteção do cancro do colo do útero após transição para o rastreio primário com teste do papilomavírus humanoestudo de ligação de dados de base populacional em Portugalen
dc.title.subtitlepopulation-based linkage study in Portugal
dc.typejournal article
degois.publication.firstPage438
degois.publication.issue8
degois.publication.lastPage447
degois.publication.titleActa Medica Portuguesa
degois.publication.volume39
dspace.entity.typePublication
rcaap.rightsopenAccess

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