{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,13]],"date-time":"2026-05-13T18:11:11Z","timestamp":1778695871132,"version":"3.51.4"},"reference-count":26,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2022,12,5]],"date-time":"2022-12-05T00:00:00Z","timestamp":1670198400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"Mobilitas Pluss","award":["MOBJD579"],"award-info":[{"award-number":["MOBJD579"]}]},{"DOI":"10.13039\/501100002301","name":"Estonian Research Council","doi-asserted-by":"publisher","award":["PRG722"],"award-info":[{"award-number":["PRG722"]}],"id":[{"id":"10.13039\/501100002301","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,2,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Despite the national cervical cancer screening programme launched in 2006, Estonia has one of the highest cervical cancer incidence rates in Europe. While the overall coverage of cervical cytology is high, the factors related to cancer screening history prior to cancer diagnosis need to be studied.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>In this study, we aimed to examine the 10-year screening history of women diagnosed with cervical cancer in Estonia in 2017\u201318, using data collected from laboratory reports from 2007 to 2018. From each report, we extracted information on the date and result of cytology and on the laboratory where the sample was assessed. We analysed these data across cancer histology, the time interval between the last test result and cancer diagnosis and the laboratory type (local or regional).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Among 319 women with cervical cancer, 181 (56.7%) did not have any cytology reports available. Among 138 women with at least one cytology, 60% had 1\u20133, 24% 4\u20136 and 16% \u22657 tests (mean 3.7) before cancer. In 78% of women, the last test was performed less than 5\u2009years before cancer diagnosis and 62% of these tests did not report any abnormalities. The last cytology results differed significantly between the regional and local laboratories (P\u2009=\u20090.028).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Women received the cervical cancer diagnosis in Estonia despite having several screening tests 10\u2009years prior to the diagnosis. The proportion of cytology tests without any abnormalities less than 5\u2009years before the diagnosis was worryingly high and needs further investigation together with the difference between laboratory types.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/eurpub\/ckac176","type":"journal-article","created":{"date-parts":[[2022,12,5]],"date-time":"2022-12-05T20:31:32Z","timestamp":1670272292000},"page":"64-68","source":"Crossref","is-referenced-by-count":8,"title":["Cervical cancer screening history among women diagnosed with cervical cancer in Estonia 2017\u201318"],"prefix":"10.1093","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6849-202X","authenticated-orcid":false,"given":"Madleen","family":"Orumaa","sequence":"first","affiliation":[{"name":"Department of Epidemiology and Biostatistics, National Institute for Health Development , Tallinn, Estonia"},{"name":"Department of Research, Cancer Registry of Norway, Oslo University Hospital , Oslo, Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kaire","family":"Innos","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, National Institute for Health Development , Tallinn, Estonia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria","family":"Suurna","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, National Institute for Health Development , Tallinn, Estonia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Piret","family":"Veerus","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics, National Institute for Health Development , Tallinn, Estonia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2022,12,5]]},"reference":[{"key":"2023020402195569900_ckac176-B1","author":"European Cancer Information System (ECIS)","year":"2022"},{"key":"2023020402195569900_ckac176-B2","doi-asserted-by":"crossref","first-page":"1075","DOI":"10.1186\/s12885-018-5006-1","article-title":"Trends in cervical cancer incidence and survival in Estonia from 1995 to 2014","volume":"18","author":"Ojamaa","year":"2018","journal-title":"BMC Cancer"},{"key":"2023020402195569900_ckac176-B3","doi-asserted-by":"crossref","first-page":"524","DOI":"10.1177\/030089161009600403","article-title":"Impact of implementing a nationwide cervical cancer screening program on female population coverage by Pap-tests in Estonia","volume":"96","author":"Veerus","year":"2010","journal-title":"Tumori"},{"key":"2023020402195569900_ckac176-B4","volume-title":"European Guidelines for Quality Assurance in Cervical Cancer Screening","author":"Arbyn","year":"2015","edition":"2nd edn."},{"key":"2023020402195569900_ckac176-B5","volume-title":"Diagnosis, Monitoring and Treatment of Pre-cancerous Changes in the Cervix, Vagina and Vulva","author":"HPV Vaccination Recommendations","year":"2014","edition":"3rd Verison"},{"key":"2023020402195569900_ckac176-B6","author":"Health Statistics and Health Research Database","year":"2022"},{"key":"2023020402195569900_ckac176-B7","author":"Health Insurance Fund","year":"2022"},{"key":"2023020402195569900_ckac176-B8","doi-asserted-by":"crossref","first-page":"102231","DOI":"10.1016\/j.canep.2022.102231","article-title":"Effect of Pap-smear and sociodemographic factors on cervical cancer risk in Estonia: a population-based case\u2013control study","volume":"80","author":"N\u00f5mm","year":"2022","journal-title":"Cancer Epidemiol"},{"key":"2023020402195569900_ckac176-B9","first-page":"330","article-title":"The validity of Estonian Cancer Registry data in 1995\u20132008","volume":"94","author":"Orumaa","year":"2015","journal-title":"Eesti Arst"},{"key":"2023020402195569900_ckac176-B10","volume-title":"Definitions, Criteria, and Explanatory Notes","author":"Nayar","year":"2015","edition":"3rd edn"},{"key":"2023020402195569900_ckac176-B11","doi-asserted-by":"crossref","first-page":"3449","DOI":"10.1002\/cam4.3857","article-title":"Risk factors of cervical cancer after a negative cytological diagnosis in Polish cervical cancer screening programme","volume":"10","author":"Macios","year":"2021","journal-title":"Cancer Med"},{"key":"2023020402195569900_ckac176-B12","doi-asserted-by":"crossref","first-page":"1040","DOI":"10.1002\/ijc.30152","article-title":"Is cervical screening preventing adenocarcinoma and adenosquamous carcinoma of the cervix?","volume":"139","author":"Castanon","year":"2016","journal-title":"Int J Cancer"},{"key":"2023020402195569900_ckac176-B13","doi-asserted-by":"crossref","first-page":"1758","DOI":"10.1002\/ijc.29541","article-title":"Cervical cancer prevented by screening: long-term incidence trends by morphology in Norway","volume":"137","author":"Lonnberg","year":"2015","journal-title":"Int J Cancer"},{"key":"2023020402195569900_ckac176-B14","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1111\/j.1365-2303.2011.00955.x","article-title":"Type 1 and type 2 cervical carcinomas: some cervical cancers are more difficult to prevent with screening","volume":"23","author":"Austin","year":"2012","journal-title":"Cytopathology"},{"key":"2023020402195569900_ckac176-B15","doi-asserted-by":"crossref","first-page":"546","DOI":"10.1016\/j.ygyno.2017.06.003","article-title":"Why does cervical cancer occur in a state-of-the-art screening program?","volume":"146","author":"Castle","year":"2017","journal-title":"Gynecol Oncol"},{"key":"2023020402195569900_ckac176-B16","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1097\/LGT.0000000000000450","article-title":"Why do women get cervical cancer in an organized screening program in Canada?","volume":"23","author":"Jackson","year":"2019","journal-title":"J Low Genit Tract 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Dissertation.","author":"Koreinik","year":"2019"},{"key":"2023020402195569900_ckac176-B23","doi-asserted-by":"crossref","first-page":"161","DOI":"10.1002\/pon.4126","article-title":"Experiences of cervical screening and barriers to participation in the context of an organised programme: a systematic review and thematic synthesis","volume":"26","author":"Chorley","year":"2017","journal-title":"Psycho-Oncology"},{"key":"2023020402195569900_ckac176-B24","doi-asserted-by":"crossref","first-page":"30","DOI":"10.1016\/j.ejca.2017.04.017","article-title":"Understanding the heterogeneity of cervical cancer screening non-participants: data from a national sample of British women","volume":"80","author":"Marlow","year":"2017","journal-title":"Eur J Cancer"},{"key":"2023020402195569900_ckac176-B25","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1177\/09691413211052499","article-title":"Human papillomavirus self-sampling for long-term non-attenders in cervical cancer screening: a randomised feasibility study in Estonia","volume":"29","author":"Veerus","year":"2022","journal-title":"J Med Screen"},{"key":"2023020402195569900_ckac176-B26","doi-asserted-by":"crossref","first-page":"106237","DOI":"10.1016\/j.ypmed.2020.106237","article-title":"The role and utility of population-based cancer registries in cervical cancer surveillance and control","volume":"144","author":"Pi\u00f1eros","year":"2021","journal-title":"Prev Med"}],"container-title":["European Journal of Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/eurpub\/advance-article-pdf\/doi\/10.1093\/eurpub\/ckac176\/47604027\/ckac176.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/eurpub\/article-pdf\/33\/1\/64\/49088876\/ckac176.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/eurpub\/article-pdf\/33\/1\/64\/49088876\/ckac176.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,2,4]],"date-time":"2023-02-04T02:22:04Z","timestamp":1675477324000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/eurpub\/article\/33\/1\/64\/6873913"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12,5]]},"references-count":26,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2022,12,5]]},"published-print":{"date-parts":[[2023,2,3]]}},"URL":"https:\/\/doi.org\/10.1093\/eurpub\/ckac176","relation":{},"ISSN":["1101-1262","1464-360X"],"issn-type":[{"value":"1101-1262","type":"print"},{"value":"1464-360X","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2023,2,1]]},"published":{"date-parts":[[2022,12,5]]}}}