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Invasive Cervical Cancer Detection After Transition to Primary Human Papillomavirus Screening: Population-Based Linkage Study in Portugal

2026-08Artigo científico Acesso aberto
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dc.contributor.authorSousa, Rita
dc.contributor.authorFonseca-Moutinho, José Alberto
dc.contributor.authorGomes, Fábio
dc.contributor.authorLoureiro, Fernanda
dc.contributor.authorNascimento, Helena
dc.contributor.authorSoalheiro, Helena
dc.contributor.authorSaavedra, Isabel
dc.contributor.authorPonte, Madalena
dc.contributor.authorBarros, Mónica
dc.contributor.authorPereira, Sofia
dc.contributor.authorRebelo, Teresa
dc.contributor.authorCaeiro, Vítor
dc.contributor.authorGoes, Ana Rita
dc.contributor.authorSoares, Patricia
dc.date.accessioned2026-09-30T10:21:48Z
dc.date.available2026-09-30T10:21:48Z
dc.date.issued2026-08
dc.description
dc.description.abstractIntroduction: Invasive cervical cancer (ICC) is a key outcome for evaluating cervical cancer screening (CCS) programs. Monitoring ICC trends and distinguishing cancers detected within and outside the organized screening program are essential for assessing program impact, particularly during transitions such as the introduction of human papillomavirus (HPV) based primary screening. Methods: We conducted a retrospective population-based study in Portugal’s Central Region (2014 - 2023). Deterministic linkage was performed between the organized CCS database and hospital morbidity records. Invasive cervical cancer cases were classified as screen-detected or non-screen detected based on prior screening history. Incidence rates were calculated using population denominators. Poisson regression models with log link and log-transformed population offsets were fitted to estimate incidence rate ratios (IRR) comparing cytology-based (2014 - 2019) and HPV-based (2020 - 2023) periods, adjusting for temporal trends. Results: A total of 654 ICC cases were included. Screening participation remained broadly stable over time. The HPV-based period was associated with a significantly higher rate of screen-detected ICC (IRR = 1.94; 95% CI 1.11 - 3.40) compared with the cytology period. In contrast, ICC incidence outside the organized screening program did not differ significantly between periods (IRR = 0.94; 95% CI 0.65 - 1.35). Conclusion: The transition to HPV-based primary screening was associated with a shift in ICC detection towards the organized screening program, without evidence of a corresponding increase in incidence among women diagnosed outside the organized screening program. These findings should, however, be interpreted with caution in light of the early phase of implementation and potential external factors influencing access to diagnosis. Overall, the results support a shift in detection within the screening pathway rather than changes in underlying disease occurrence. Strengthening integration between screening, hospital, and cancer registry data remains essential for robust evaluation of cervical cancer screening policies.eng
dc.description.sponsorshipFCT - reference: CEEC- INST/00049/2021/CP2817/CT0001 and https://doi. org/10.54499/CEECINST/00049/2021/CP2817/CT0001
dc.identifier.citationActa Med Port. 2026 Aug 3;39(8):438-447. doi: 10.20344/amp.24709. Epub 2026 Aug 3
dc.identifier.doi10.20344/amp.24709
dc.identifier.eissn1646-0758
dc.identifier.pmid42556424
dc.identifier.urihttp://hdl.handle.net/10400.18/11353
dc.language.isoeng
dc.peerreviewedyes
dc.relationINST/00049/2021/CP2817/CT0001
dc.relation.hasversionhttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/24709
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
dc.subjectHPV
dc.subjectEarly Detection of Cancer
dc.subjectMedical Record Linkage
dc.subjectPapillomaviridae
dc.subjectPapillomavirus Infections
dc.subjectUterine Cervical Neoplasms
dc.subjectCervical Cancer
dc.subjectEpidemiology
dc.subjectInfecções Sexualmente Transmissíveis
dc.subjectEstados de Saúde e de Doença
dc.subjectPortugal
dc.titleInvasive Cervical Cancer Detection After Transition to Primary Human Papillomavirus Screening: Population-Based Linkage Study in Portugaleng
dc.typejournal article
dcterms.referenceshttps://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/24709/15995
dspace.entity.typePublication
oaire.citation.endPage447
oaire.citation.issue8
oaire.citation.startPage438
oaire.citation.titleActa Médica Portuguesa
oaire.citation.volume39
oaire.versionhttp://purl.org/coar/version/c_970fb48d4fbd8a85
person.familyNameSoares
person.givenNamePatricia
person.identifier1050496
person.identifier.ciencia-id0415-632D-8609
person.identifier.orcid0000-0001-5033-9115
person.identifier.scopus-author-id52063758300
relation.isAuthorOfPublicationdf1b8bab-1e35-4561-92d0-8aeb17371a29
relation.isAuthorOfPublication.latestForDiscoverydf1b8bab-1e35-4561-92d0-8aeb17371a29

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