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Gynecol Oncol ; 162(2): 315-321, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34074539

RESUMO

OBJECTIVE: It has been proposed that cervical cancer screening should be continued in women with previous abnormal results or irregular attendance. We examined the coverage and factors that might influence cervical testing beyond the age range of the organized cervical screening programme in Finland. The national programme invites women in every five years least until the age of 60. After the stopping age, only opportunistic service is available. METHODS: Data on cervical testing were collected from the Mass Screening Registry and providers of opportunistic Pap/HPV-testing and were linked with information on socio-economic variables. The study included 373,353 women who had at least one invitation to the national screening programme between ages 50-60 years, and who were aged 65-74 years in the follow-up period 2006-2016. Multivariable binomial regression models were conducted to determine associations. RESULTS: Altogether 33% of the study population had been tested at least once at ages 65-74 years. Previous regular screening attendance (adjRR 1.70; 95% CI 1.67-1.73) and earlier abnormal results (adjRR 2.08; 95% CI 2.04-2.12) were most clearly related to higher testing adherence at older age. Other factors related to higher testing adherence were urban area of residence, domestic mother tongue, high education level, and high socio-economic status. CONCLUSION: Testing at older age was frequent with normal results, whereas only a small proportion of women with earlier abnormal results or irregular attendance were tested. The upper age limit of the national programme should be raised to 65 years, and the invitations thereafter should be targeted to selected high-risk groups.


Assuntos
Detecção Precoce de Câncer/estatística & dados numéricos , Infecções por Papillomavirus/diagnóstico , Cooperação do Paciente/estatística & dados numéricos , Displasia do Colo do Útero/diagnóstico , Neoplasias do Colo do Útero/prevenção & controle , Adulto , Assistência ao Convalescente , Fatores Etários , Idoso , Colo do Útero/patologia , Colo do Útero/virologia , Estudos de Coortes , Detecção Precoce de Câncer/economia , Detecção Precoce de Câncer/normas , Feminino , Finlândia , Disparidades em Assistência à Saúde/estatística & dados numéricos , Humanos , Cobertura do Seguro/economia , Cobertura do Seguro/normas , Cobertura do Seguro/estatística & dados numéricos , Pessoa de Meia-Idade , Teste de Papanicolaou/economia , Teste de Papanicolaou/normas , Teste de Papanicolaou/estatística & dados numéricos , Infecções por Papillomavirus/economia , Infecções por Papillomavirus/patologia , Infecções por Papillomavirus/virologia , Sistema de Registros/estatística & dados numéricos , Fatores Socioeconômicos , Neoplasias do Colo do Útero/patologia , Neoplasias do Colo do Útero/virologia , Esfregaço Vaginal/economia , Esfregaço Vaginal/estatística & dados numéricos , Displasia do Colo do Útero/economia , Displasia do Colo do Útero/patologia , Displasia do Colo do Útero/virologia
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