Risk of vaginal cancer among hysterectomised women with cervical intraepithelial neoplasia: a population-based national cohort study.
Adult
Case-Control Studies
Cohort Studies
Cross-Sectional Studies
Female
Humans
Hysterectomy
/ statistics & numerical data
Incidence
Middle Aged
Papillomavirus Infections
/ complications
Registries
Risk Factors
Sweden
/ epidemiology
Vaginal Neoplasms
/ epidemiology
Uterine Cervical Dysplasia
/ epidemiology
Cervical intraepithelial neoplasia
cervical intraepithelial neoplasia stage 3
follow up
hysterectomy
surveillance
vaginal cancer
Journal
BJOG : an international journal of obstetrics and gynaecology
ISSN: 1471-0528
Titre abrégé: BJOG
Pays: England
ID NLM: 100935741
Informations de publication
Date de publication:
03 2020
03 2020
Historique:
accepted:
18
11
2019
pubmed:
27
11
2019
medline:
4
3
2020
entrez:
27
11
2019
Statut:
ppublish
Résumé
To study the risk of vaginal cancer among hysterectomised women with and without cervical intraepithelial neoplasia (CIN). Population-based national cohort study. All Swedish women, 5 million in total, aged 20 and up, 1987-2011 using national registries. The study cohort was subdivided into four exposure groups: hysterectomised with no previous history of CIN3 and without prevalent CIN at hysterectomy; hysterectomised with a history of CIN3/adenocarcinoma in situ (AIS); hysterectomised with prevalent CIN at hysterectomy; non-hysterectomised. Vaginal cancer. We identified 898 incident cases of vaginal cancer. Women with prevalent CIN at hysterectomy and those with a history of CIN3/AIS had incidence rates (IR) of vaginal cancer of 51.3 (95% CI 34.4-76.5) and 17.1 (95% CI 12.5-23.4) per 100 000, respectively. Age-adjusted IR-ratios (IRRs) compared with hysterectomised women with benign cervical history were 21.0 (95% CI 13.4-32.9) and 5.81 (95% CI 4.00-8.43), respectively. IR for non-hysterectomised women was 0.87 (95% CI 0.81-0.93) and IRR was 0.37 (95% CI 0.30-0.46). In hysterectomised women with prevalent CIN, the IR remained high after 15 years of follow up: 65.7 (95% CI 21.2-203.6). Our findings suggest that hysterectomised women with prevalent CIN at surgery should be offered surveillance. Hysterectomised women without the studied risk factors have a more than doubled risk of contracting vaginal cancer compared with non-hysterectomised women in the general population. Still, the incidence rate does not justify screening. High risk of contracting vaginal cancer among hysterectomised women having prevalent CIN at surgery.
Identifiants
pubmed: 31769577
doi: 10.1111/1471-0528.16028
doi:
Types de publication
Journal Article
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
448-454Subventions
Organisme : Hjalmar Svensson Foundation
ID : HJSV2018066
Pays : International
Commentaires et corrections
Type : CommentIn
Informations de copyright
© 2019 Royal College of Obstetricians and Gynaecologists.
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