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Risk of cervical and other cancers after treatment of cervical intraepithelial neoplasia: retrospective cohort study

BMJ 2005; 331 doi: https://doi.org/10.1136/bmj.38663.459039.7C (Published 17 November 2005) Cite this as: BMJ 2005;331:1183
  1. Ilkka Kalliala, researcher (ilkka.kalliala{at}helsinki.fi)1,
  2. Ahti Anttila, research director2,
  3. Eero Pukkala, director of statistics3,
  4. Pekka Nieminen, senior consultant1
  1. Department of Obstetrics and Gynaecology, Helsinki University Central Hospital, Box 140, FIN-00029, Helsinki, Finland
  2. Mass Screening Registry, Finnish Cancer Registry, Liisankatu 21 B, FIN-00170, Helsinki, Finland
  3. Finnish Cancer Registry, Liisankatu 21 B, FIN-00170, Helsinki, Finland
  1. Correspondence to: I Kalliala
  • Accepted 21 October 2005

Abstract

Objective To study the long term risk of cervical and other cancers after treatment for cervical intraepithelial neoplasia.

Design Retrospective cohort study.

Setting University Hospital, Helsinki, Finland.

Participants 7564 women treated for cervical intraepithelial neoplasia during 1974 and 2001 and followed up through the Finnish cancer registry until 2003.

Main outcome measures Standardised incidence ratio for cervical cancer and other cancers.

Results During follow-up 22 cases of invasive cervical cancer occurred in women treated for cervical intraepithelial neoplasia (standardised incidence ratio 2.8, 95% confidence interval 1.7 to 4.2). The highest risk was during the second decade (10 cases observed: 3.1, 1.5 to 5.7). The standardised incidence ratio for cervical intraepithelial cancer type 1 was 3.1 (1.4 to 6.2) and for type 2 was 3.7 (0.9 to 10.7).

Conclusions The risk of cervical cancer in the first 20 years after treatment for cervical intraepithelial neoplasia is higher than in the average population. The risk of smoking related cancers is also increased.

Footnotes

  • Contributors IK contributed to the study conception and design, analysis and interpretation of the data, and drafting the manuscript. AA contributed to the study conception and design, interpretation of the data, and drafting and revising the manuscript. EP contributed to the analysis and interpretation of the data and drafting the article. PN contributed to the study conception and design, interpretation of the data, and drafting and revising the manuscript. He is guarantor.

  • Funding This study was partially financed from a grant from the Finnish Cancer Organisation.

  • Competing interests None declared.

  • Ethical approval This study was approved by the ethical committee of obstetrics and gynecology E8 of the Helsinki-Uusimaa hospital district (decision No 150/E8/03).

  • Accepted 21 October 2005
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