Cervical cancer screening and related procedures among women under 25 years of age between 2007 and 2013 in France: a study based on French medical-administrative databases.
Introduction: French guidelines set the age for initiating cervical cancer screening via Pap smear at 25 years. The frequent spontaneous regression of lesions resulting from human papillomavirus (HPV) infection in younger women diminishes the value of this screening, which may lead to unnecessary and potentially harmful surgical procedures. No national data exist on this screening or on the proportion of diagnostic and surgical procedures resulting from it. Methods: Using French medical-administrative databases (Sniiram-PMSI), the proportion of FCU screenings performed before the recommended age, as well as the proportion of women aged 15 to 24 who underwent at least one FCU in the past year and in the past three years, over the 2007–2013 period, were calculated using data from the general health insurance system and then extrapolated to the population residing in France. Diagnostic and surgical procedures reimbursed within 15 months of a Pap smear among women aged 20 to 24 were described for 2007 and 2012. Results: For each year of the study, approximately 10% of women who had at least one reimbursed Pap test in the year were under 25 years of age, primarily aged 20 to 24. In 2013, among women aged 20 to 24, 16.2% had had at least one Pap test in the year and 35.5% at least one in the three years. In this population, the use of HPV testing following a Pap smear increased significantly over the study period (+105%). Surgical management appears to have become more aggressive, as evidenced by an increase in the proportion of screened women who underwent conization (+16.5%) or other types of excision (+74.5%) in the year following their first FCU. Nevertheless, with the overall decline in FCU screening, the absolute annual number of women undergoing conization decreased, falling from 1,974 to 1,766 between 2007 and 2012. Conclusions: Better adherence to recommendations is necessary to reduce cervical cancer screening among young women and its potential consequences in terms of obstetric morbidity.
Author(s): Maura G, Chaignot C, Weill A, Alla F, Heard I
Publishing year: 2017
Pages: 32-8
Weekly Epidemiological Bulletin, 2017, n° 2-3, p. 32-8
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