Abstract:
BACKGROUND:In 2017, the Dutch cervical cancer screening program had replaced the primary cytology-based screening with primary high-risk human papillomavirus-based screening, including the opportunity to participate through self-sampling. Evaluation and balancing benefit (detection of high-grade cervical intraepithelial neoplasia) and burden of screening (unnecessary referrals, invasive diagnostics, and overtreatment) is needed. OBJECTIVE:This study aimed to compare the referral rates, detection of high-grade cervical intraepithelial neoplasia, overdiagnosis, and overtreatment in the new high-risk human papillomavirus-based screening program, including physician-sampled and self-sampled material, with the previous cytology-based screening program in the Netherlands. STUDY DESIGN:A retrospective cohort study was conducted within the Dutch population-based cervical cancer screening program. Screenees with referrals for colposcopy between 2014 and 2015 (cytology-based screening) and 2017 and 2018 (high-risk human papillomavirus-based screening) were included. Data were retrieved from the Dutch Pathology Registry (PALGA) and compared between the 2 screening programs. The main outcome measures were referral rate, detection of high-grade cervical intraepithelial neoplasia or worse, overdiagnosis (cervical intraepithelial neoplasia grade 1 or less in the histologic specimen), and overtreatment (cervical intraepithelial neoplasia grade 1 or less in the treatment specimen). RESULTS:Of the women included in the study, 19,109 received cytology-based screening, and 26,171 received high-risk human papillomavirus-based screening. Referral rates increased from 2.5% in cytology-based screening to 4.2% in high-risk human papillomavirus-based screening (+70.2%). Detection rates increased to 46.2% for cervical intraepithelial neoplasia grade 2 or worse, 32.2% for cervical intraepithelial neoplasia grade 3 or worse, and 31.0% for cervical cancer, and overdiagnosis increased to 143.4% with high-risk human papillomavirus-based screening. Overtreatment rates were similar in both screening periods. The positive predictive value of referral for detection of cervical intraepithelial neoplasia grade 2 or worse in high-risk human papillomavirus-based screening was 34.6% compared with 40.2% in cytology-based screening. Women screened through self-sampling were at higher risk of cervical intraepithelial neoplasia grade 2 or worse detection (odds ratio, 1.38; 95% confidence interval, 1.20-1.59) and receiving treatment (odds ratio, 1.31; 95% confidence interval, 1.16-1.48) than those screened through physician-sampling. CONCLUSION:Compared with cytology-based screening, high-risk human papillomavirus-based screening increases detection of high-grade cervical intraepithelial neoplasia, with 462 more cervical intraepithelial neoplasia grade 2 or worse cases per 100,000 women but at the expense of 850 more cases per 100,000 women with invasive diagnostics indicating cervical intraepithelial neoplasia grade 1 or less.
journal_name
Am J Obstet Gynecoljournal_title
American journal of obstetrics and gynecologyauthors
Loopik DL,Koenjer LM,Siebers AG,Melchers WJG,Bekkers RLMdoi
10.1016/j.ajog.2020.08.026subject
Has Abstractpub_date
2020-08-13 00:00:00eissn
0002-9378issn
1097-6868pii
S0002-9378(20)30854-1pub_type
杂志文章abstract:OBJECTIVE:Our purpose was to assess the effects of labor and antigestagens on production of interleukin 8 by the term human placenta and to localize interleukin 8 in first- and third- trimester placentas. STUDY DESIGN:The study was conducted by the Department of Obstetrics and Gynaecology of the University of Edinburg...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(98)70275-3
更新日期:1998-07-01 00:00:00
abstract::The practice of gynecological surgery is being reshaped by commercial interests that are promoting the use of trochar-and-mesh surgical kits for the treatment of stress incontinence and pelvic organ prolapse. In this article, we review the recent history of these surgical innovations and discuss the implications of ch...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2009.05.031
更新日期:2010-01-01 00:00:00
abstract:BACKGROUND:Cesarean scar pregnancy and cervical pregnancy are unrelated forms of pathological pregnancies carrying significant diagnostic and treatment challenges, with a wide range of treatment effectiveness and complication rates ranging from 10% to 62%. At times, life-saving hysterectomy and uterine artery embolizat...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2016.03.010
更新日期:2016-09-01 00:00:00
abstract:OBJECTIVE:The objective of the study was to examine risk factors for bacterial vaginosis (BV) during pregnancy among African American women. STUDY DESIGN:As part of a study of preterm birth, African American women residing in Baltimore, MD, were recruited from prenatal care sites. Women enrolled prenatally (between 22...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ajog.2007.03.085
更新日期:2007-11-01 00:00:00
abstract:OBJECTIVE:Our goal was to determine whether there are racial differences in the severity of illness on admission for premature newborn infants independent of gestational age. STUDY DESIGN:The study population consisted of all African American and Caucasian singleton infants with gestational ages <34 weeks who were adm...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/mob.2001.109941
更新日期:2001-03-01 00:00:00
abstract::One hundred fifty-eight intravenous saline solution infusions (3 mmol Na per kilogram body weight) were performed in (1) normal primigravid women during the second and third trimesters and post partum, after 1 week of either a high, low, or ad libitum salt intake; (2) normotensive primigravid women during midpregnancy...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(88)80071-1
更新日期:1988-08-01 00:00:00
abstract::Three cases of anaphylactic reactions associated with the use of intravenous cefotetan as surgical prophylaxis for cesarean section (two cases) and transabdominal hysterectomy (one case) are presented. Comprehensive review of these cases revealed no evidence of lot-specific association, drug-drug interaction, or metho...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(88)90506-6
更新日期:1988-07-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to investigate the diagnostic impact of preoperative serum p53 antibody (S-p53 Ab) in patients with endometrial cancer. STUDY DESIGN:A hospital-based series of 67 patients, comprising 58 endometrioid adenocarcinomas (EA) and 9 serous adenocarcinomas (SA) between 1998-2002 were i...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2007.04.033
更新日期:2007-11-01 00:00:00
abstract:OBJECTIVE:We conducted, in a randomized, placebo-controlled manner, behavioral testing on mice offspring exposed antenatally to the herbal antidepressant Saint John's wort (Hypericum ). STUDY DESIGN:A daily dose of Saint John's wort (0.75 mg/g of food consumed), equivalent to that in human beings according to body sur...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/mob.2000.108889
更新日期:2000-11-01 00:00:00
abstract:OBJECTIVE:We combined data from published reports of the relation between estrogen use and breast cancer. We specifically addressed the hypothesis that the addition of progestins to estrogen therapy reduces the risk of breast cancer. STUDY DESIGN:A meta-analysis was performed. RESULTS:Replacement hormone therapy is n...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,meta分析
doi:10.1016/s0002-9378(11)90784-4
更新日期:1993-05-01 00:00:00
abstract::The pathogenesis of endometriosis is controversial. The two principal histogenetic theories are (1) metastases of endometrial tissues to an ectopic location (metastatic theory) and (2) metaplastic development of endometrial tissue at the ectopic site (metaplastic theory). Studies on the development of the coelomic cav...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章,评审
doi:10.1016/0002-9378(91)90255-p
更新日期:1991-07-01 00:00:00
abstract::Amniotic fluid testosterone was assayed by radioimmunoassay in 812 samples taken at 16 weeks' gestation at the time of genetic amniocentesis. In each of 361 samples (45% of total), correct assignment of fetal sex was made where the testosterone level was above 33.8 ng/ml for male fetuses and below 16.2 ng/ml for femal...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(80)90854-6
更新日期:1980-02-01 00:00:00
abstract::A 15-year-old girl with papillary serous carcinoma of the peritoneum was seen with abdominal distention, ascites, and elevated CA 125 tumor marker. After other therapy failed, she achieved complete and continuing remission with paclitaxel. ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(95)90046-2
更新日期:1995-03-01 00:00:00
abstract::To describe normal relationships between the various plasma unconjugated estrogens and progesterone during the second half of human pregnancy, the plasma concentrations of progesterone, 17-hydroxyprogesterone (17-OHP), and unconjugated estrone (E1), estradiol (E2), and estriol (E3) were measured in 126-310 normal wom...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(72)90185-8
更新日期:1972-04-15 00:00:00
abstract:OBJECTIVE:Although a few studies have evaluated the effect of meconium on the lecithin/sphingomyelin ratio for testing of fetal lung maturity, to date these studies have assessed only the lecithin-sphingomyelin ratio of amniotic fluid contaminated with meconium. The purpose of this study was (1) to determine whether me...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(98)70038-9
更新日期:1998-12-01 00:00:00
abstract:OBJECTIVE:We compared demographic characteristics of first-year residents entering obstetrics/gynecology with those entering primary care and surgery. STUDY DESIGN:We analyzed first-year residents from the 1997-2004 National Graduate Medical Education Census. Multivariable logistic regression models identified indepen...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2007.07.031
更新日期:2007-11-01 00:00:00
abstract::A total of 26 patients with sickle cell disease were followed up through 32 pregnancies. There was no correlation between days in hospital or number of painful crises and either birth weight or birth weight percentile. The number of dense irreversibly sickled and least deformable cells was negatively correlated with b...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(89)90372-4
更新日期:1989-09-01 00:00:00
abstract::Of 128 patients receiving primary treatment for molar pregnancy at Women's Hospital, Los Angeles County/University of Southern California Medical Center, after uterine evacuation 12 (10.7%) developed self-limited, acute pulmonary complications characterized by tachycardia, tachypnea, and hypoxemia. Multiple contributi...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(79)90341-7
更新日期:1979-09-15 00:00:00
abstract:OBJECTIVES:Our purpose was to develop a method to induce premature delivery in rats and to use this method to identify biochemical changes that are critical to cervical dilatation by comparison to changes that occur during term delivery. STUDY DESIGN:Rats were treated with antiprogestational agents onapristone or lilo...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1053/ob.1996.v175.a74254
更新日期:1996-09-01 00:00:00
abstract::The application of the Home Ovarian Hormone Monitor to the avoidance of pregnancy by periodic abstinence has been explored. No woman had difficulty with the daily urine testing, and their results consistently identified the distinctive hormone pattern of the ovulatory cycle and the day of ovulation and correlated clos...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(11)90568-7
更新日期:1991-12-01 00:00:00
abstract:OBJECTIVE:The purpose of our study was to explore the urinary responses of the ovine fetus to indomethacin levels comparable with those used therapeutically in the human fetus. STUDY DESIGN:After a 1-hour control period, chronically catheterized ovine fetuses between 125 and 139 days of gestation were given an intrave...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(92)91767-5
更新日期:1992-12-01 00:00:00
abstract:BACKGROUND:Induction of labor occurs in >20% of pregnancies, which equates to approximately 1 million women undergoing an induction in the United States annually. Regardless of how common inductions are, our ability to predict induction success is limited. Although multiple risk factors for a failed induction have been...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2017.11.603
更新日期:2018-02-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to report the clinical experience collated from the 1995 and 1997 case list summary sheets of United States and Canadian active candidates who were completing the American Board of Obstetrics and Gynecology oral examination for the first time. STUDY DESIGN:Data from the case lis...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1067/mob.2001.119181
更新日期:2001-12-01 00:00:00
abstract::Paired maternal and fetal atrial natriuretic peptide concentrations were measured in 62 percutaneous umbilical blood samplings performed principally for the assessment and treatment of rhesus isoimmunization. Pretransfusion fetal atrial natriuretic peptide levels were significantly higher than maternal atrial natriure...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(91)90419-r
更新日期:1991-10-01 00:00:00
abstract::In this study, we examined whether the doubling time of human chorionic gonadotropin is different at different stages of early pregnancy and whether the use of multiple nomograms for doubling time of human chorionic gonadotropin rather than a single critical value can improve the diagnosis of ectopic pregnancy. Forty-...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(87)80349-6
更新日期:1987-07-01 00:00:00
abstract::Charts from 482 singleton pregnancies undergoing cerclage placement in patients over a 6-year period were reviewed. Cervical dilatation at time of surgery, number of previous spontaneous losses, and gestational age at placement were key determinants of outcome. The most frequent complication, premature rupture of the ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(91)90283-w
更新日期:1991-09-01 00:00:00
abstract:OBJECTIVES:The purpose of this study was to determine the effect of magnesium sulfate on protein kinase C (PKC) translocation in myometrial cells from pregnant women. STUDY DESIGN:Myometrium was obtained at the time of cesarean delivery from women at term before labor. Cultured myometrial cells were treated with magne...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/j.ajog.2003.09.009
更新日期:2004-02-01 00:00:00
abstract::A case of nonimmune hydrops fetalis in association with angioosteohypertrophy (Klippel-Trenaunay) syndrome is reported for the first time. ...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/0002-9378(88)90443-7
更新日期:1988-11-01 00:00:00
abstract::To test the hypothesis that intrauterine insemination with washed spermatozoa induces antisperm antibody formation, we measured serum antisperm antibody levels by the Immunobead technique in a population of women receiving exogenous gonadotropins. Antibody levels were measured before therapy (baseline) and then serial...
journal_title:American journal of obstetrics and gynecology
pub_type: 杂志文章
doi:10.1016/s0002-9378(89)80045-6
更新日期:1989-03-01 00:00:00
abstract:OBJECTIVE:Our purpose was to study maternal blood and amniotic fluid concentrations of homocysteine and relevant vitamins in relation to neural tube defects. STUDY DESIGN:Concentrations of total homocysteine, folate, and vitamins B12 and B6 were measured in maternal blood and amniotic fluid of 27 women carrying a fetu...
journal_title:American journal of obstetrics and gynecology
pub_type: 临床试验,杂志文章
doi:10.1016/0002-9378(95)90474-3
更新日期:1995-05-01 00:00:00