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Cervical cancer screening in Belgium and overscreening of adolescents

HELENA VAN KERREBROECK (UGent) and Amin Makar (UGent)
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Abstract
There has been a marked decrease in the incidence of cervical cancer thanks to cytological screening with the Pap smear test. In Belgium, this screening is rather opportunistic. Over 39% of Belgian women between 25 and 64 years of age are never or only rarely screened by cytological tests. Moreover, there is an excess use of Pap smears because of women who rely on their yearly cervical smear and because many Pap smears are obtained from women beyond the target age range of 25 to 64 years. Sexually active adolescents are increasingly being recognized as a population distinct from adult women. They are at a high risk of acquiring the human papillomavirus (HPV), but most infections and cervical intraepithelial lesions caused by HPV are efficiently cleared by the immune system. We present a description of cervical cancer screening in Belgium using the database of the National Health Insurance Institute (RIZIV/INAMI) and the Belgian Health Care Knowledge Centre (KCE). We describe why elimination of Pap testing in the adolescent population reduces costs and harms without increasing cervical cancer rates. Expectant management, education on the risk factors for cervical cancer and HPV persistence, and HPV vaccination are very important in adolescents and young adults.
Keywords
HUMAN-PAPILLOMAVIRUS INFECTION, HPV VACCINATION PROGRAM, YOUNG-WOMEN, UNITED-STATES, INTRAEPITHELIAL NEOPLASIA, PAPANICOLAOU TESTS, NETHERLANDS, RISK, ABNORMALITIES, REGRESSION, adolescents, Belgium, cancer, cervix, epidemiology, prevention, screening

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Chicago
VAN KERREBROECK, HELENA, and Amin Makar. 2016. “Cervical Cancer Screening in Belgium and Overscreening of Adolescents.” European Journal of Cancer Prevention 25 (2): 142–148.
APA
VAN KERREBROECK, H., & Makar, A. (2016). Cervical cancer screening in Belgium and overscreening of adolescents. EUROPEAN JOURNAL OF CANCER PREVENTION, 25(2), 142–148.
Vancouver
1.
VAN KERREBROECK H, Makar A. Cervical cancer screening in Belgium and overscreening of adolescents. EUROPEAN JOURNAL OF CANCER PREVENTION. 2016;25(2):142–8.
MLA
VAN KERREBROECK, HELENA, and Amin Makar. “Cervical Cancer Screening in Belgium and Overscreening of Adolescents.” EUROPEAN JOURNAL OF CANCER PREVENTION 25.2 (2016): 142–148. Print.
@article{8500483,
  abstract     = {There has been a marked decrease in the incidence of cervical cancer thanks to cytological screening with the Pap smear test. In Belgium, this screening is rather opportunistic. Over 39% of Belgian women between 25 and 64 years of age are never or only rarely screened by cytological tests. Moreover, there is an excess use of Pap smears because of women who rely on their yearly cervical smear and because many Pap smears are obtained from women beyond the target age range of 25 to 64 years. Sexually active adolescents are increasingly being recognized as a population distinct from adult women. They are at a high risk of acquiring the human papillomavirus (HPV), but most infections and cervical intraepithelial lesions caused by HPV are efficiently cleared by the immune system. We present a description of cervical cancer screening in Belgium using the database of the National Health Insurance Institute (RIZIV/INAMI) and the Belgian Health Care Knowledge Centre (KCE). We describe why elimination of Pap testing in the adolescent population reduces costs and harms without increasing cervical cancer rates. Expectant management, education on the risk factors for cervical cancer and HPV persistence, and HPV vaccination are very important in adolescents and young adults.},
  author       = {VAN KERREBROECK, HELENA and Makar, Amin},
  issn         = {0959-8278},
  journal      = {EUROPEAN JOURNAL OF CANCER PREVENTION},
  keywords     = {HUMAN-PAPILLOMAVIRUS INFECTION,HPV VACCINATION PROGRAM,YOUNG-WOMEN,UNITED-STATES,INTRAEPITHELIAL NEOPLASIA,PAPANICOLAOU TESTS,NETHERLANDS,RISK,ABNORMALITIES,REGRESSION,adolescents,Belgium,cancer,cervix,epidemiology,prevention,screening},
  language     = {eng},
  number       = {2},
  pages        = {142--148},
  title        = {Cervical cancer screening in Belgium and overscreening of adolescents},
  url          = {http://dx.doi.org/10.1097/CEJ.0000000000000155},
  volume       = {25},
  year         = {2016},
}

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