ORCID Profile
0000-0002-8893-8620
Current Organisation
University of Aberdeen
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Publisher: Public Library of Science (PLoS)
Date: 03-2018
Publisher: Oxford University Press (OUP)
Date: 07-08-2018
Publisher: BMJ
Date: 11-2002
DOI: 10.1046/J.1525-1438.2002.01116.X
Abstract: Changes to the present age policy of cervical screening are currently under consideration. We conducted a retrospective matched case-control study and cost analysis study to identify risk factors for the development of an abnormal smear after age 50 and to determine the impact of age-restricted cervical screening on the annual cost of the screening program. All women (229) from an 11-year birth cohort who developed an abnormal smear at age 50 or over were age-matched for two controls with negative smears. Routine screening smears taken between age 48 and 52 were tested for human papillomavirus (HPV) subtypes 16 and 18. Epidemiologic data were collected by postal questionnaire. Changes in costs under a policy of HPV testing and age-restricted screening were assessed. We found that HPV 16 status was the only independently significant risk factor for abnormal cytology after age 50 with an odds ratio of 10.26 (95% CI 1.25-84.11). A policy of early withdrawal from screening at age 50 on the basis of HPV testing would produce net cost savings. These findings suggest that HPV testing could be a valuable means of identifying the small proportion of women still at risk after 50, and of releasing health care resources.
Publisher: Wiley
Date: 05-07-2019
DOI: 10.1002/CAM4.1879
Abstract: Infections with human papillomavirus (HPV) types 16 and 18 account for ~70% of invasive cervical cancers but the degree of protection from naturally acquired anti‐HPV antibodies is uncertain. We examined the risk of HPV infections as defined by HPV DNA detection and cervical abnormalities among women years in the Human Papilloma VIrus Vaccine Immunogenicity ANd Efficacy trial's (VIVIANE, NCT00294047) control arm. Serum anti‐HPV‐16/18 antibodies were determined at baseline and every 12 months in baseline DNA‐negative women (N = 2687 for HPV‐16 and 2705 for HPV‐18) by enzyme‐linked immunosorbent assay (ELISA) from blood s les. HPV infections were identified by polymerase chain reaction (PCR) every 6‐months, and cervical abnormalities were confirmed by cytology every 12 months. Data were collected over a 7‐year period. The association between the risk of type‐specific infection and cervical abnormalities and serostatus was assessed using Cox proportional hazard models. Risk of newly detected HPV‐16‐associated 6‐month persistent infections (PI) (hazard ratio [HR] = 0.56 [95%CI:0.32 0.99]) and atypical squamous cells of undetermined significance (ASC‐US+) (HR = 0.28 [0.12 0.67]) were significantly lower in baseline seropositive vs baseline seronegative women. HPV‐16‐associated incident infections (HR = 0.81 [0.56 1.16]) and 12‐month PI (HR = 0.53 [0.24 1.16]) showed the same trend. A similar trend of lower risk was observed in HPV‐18‐seropositive vs ‐seronegative women (HR = 0.95 [0.59 1.51] for IIs, HR = 0.43 [0.16 1.13] for 6‐month PIs, HR = 0.31 [0.07 1.36] for 12‐month PIs, and HR = 0.61 [0.23 1.61] for ASC‐US+). Naturally acquired anti‐HPV‐16 antibodies were associated with a decreased risk of subsequent infection and cervical abnormalities in women years. This possible protection was lower than that previously reported in 15‐ to 25‐year‐old women.
Publisher: Elsevier BV
Date: 10-2016
Publisher: Elsevier BV
Date: 12-2014
Location: United Kingdom of Great Britain and Northern Ireland
No related grants have been discovered for Margaret Cruickshank.