Impact of opportunistic testing in a systematic XXXX screening program: a nationwide registry study.

@entity1 @entity14748 @entity5 @entity854 @entity1613
BACKGROUND: Systematic screening for @entity1613 has resulted in decreased incidence and mortality of @entity5 . However, even in systematic screening programs, many @entity1 are still tested opportunistically. This study aimed to determine the spread of opportunistic testing in a systematic @entity5 screening program, the impact of opportunistic testing in terms of detecting cytological abnormalities and examine the associations between sociodemography and opportunistic testing. METHODS: A nationwide registry study was undertaken including @entity1 aged 23-49 years (n   =   807,624) with a cervical cytology between 2010 and 2013. The @entity1 were categorised into: 1) screening after invitation; 2) routine opportunistic testing, if they were either tested more than 9 months after the latest invitation or between 2.5 years and 3 years after the latest cervical cytology and 3) sporadic opportunistic testing, if they were tested less than 2.5 years after the latest cervical cytology. Cytological diagnoses of @entity1 in each of the categories were identified and @entity14748 ( @entity14748 ) and 95% confidence intervals (CIs) were used to explore group differences. Associations between sociodemography and undergoing opportunistic testing were established by multinomial logistic regression. RESULTS: In total, 28.8% of the cervical cytologies were due to either routine (20.7%) or sporadic (8.1%) opportunistic testing. Among @entity1 undergoing routine opportunistic testing, a larger proportion had high-grade squamous @entity854 than invited @entity1 ( @entity14748 : 0.6%, 95 % CI: 0.03-1.17%). A similar proportion of cytological abnormalities among @entity1 undergoing sporadic opportunistic testing and invited @entity1 was found. In multivariate analyses, younger age, being single or a social welfare recipient and residence region (North Denmark) were especially associated with opportunistic testing (routine or sporadic). CONCLUSIONS: One fourth of cervical cytologies in this study were collected opportunistically. Compared to invited @entity1 , @entity1 undergoing routine opportunistic testing were more likely to be diagnosed with abnormal cytologies. Hence, routine opportunistic testing might serve as an important supplement to the systematic screening program by covering non-participating @entity1 who may otherwise be tested with a delay or not tested at all. Among @entity1 tested more often than recommended (sporadic testing), no benefits in terms of detecting more cytological abnormalities were identified.
