Reduction of cervical cancer incidence within a primary HPV screening pilot project (WOLPHSCREEN) in Wolfsburg, Germany
Background Randomised controlled trials showed human papillomavirus (HPV)-based screening leads to a significant reduction in cervical cancer incidence compared with cytology-based screening only. Methods Non-hysterectomised participants ≥30 years underwent co-testing with Papanicolaou (Pap) smear a...
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| Veröffentlicht in: | British journal of cancer 2019-05, Vol.120 (10), p.1015-1022 |
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| creator | Horn, Johannes Denecke, Agnieszka Luyten, Alexander Rothe, Beate Reinecke-Lüthge, Axel Mikolajczyk, Rafael Petry, Karl Ulrich |
| description | Background
Randomised controlled trials showed human papillomavirus (HPV)-based screening leads to a significant reduction in cervical cancer incidence compared with cytology-based screening only.
Methods
Non-hysterectomised participants ≥30 years underwent co-testing with Papanicolaou (Pap) smear and HR-HPV testing (Hybrid Capture 2; HC2). Women with normal findings had their next screening round after 5 years, and HC2+ and Pap abnormal cases were immediately referred for colposcopy, while cases with discordant findings had repeat testing after 12 months with referral to colposcopy in cases with persistent positive findings.
Results
Twenty-six thousand six hundred and twenty-four women were recruited between February 2006 and December 2016. Two hundred and seventy-four CIN3+ cases were diagnosed (270 HPV+, 4 HPV−), including 31 invasive cervical cancers (29 HPV+, 2 HPV−). No CIN3+ was detected in HPV− women with abnormal cytology. We observed a significant decline in the 5-year incidence of CIN3+ (from 0.96% [95% CI 0.85–1.09%] to 0.16% [95% CI 0.10–0.25%];
p
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| doi_str_mv | 10.1038/s41416-019-0453-2 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_6734660</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2225133522</sourcerecordid><originalsourceid>FETCH-LOGICAL-c470t-fc4472e89ae9989f4d03c35483d42c56aec3c349aa223afe4516590dc1de20163</originalsourceid><addsrcrecordid>eNp1UdtqGzEQFaWlcd1-QF-KoC8pdFtdd6WXQDFOXDBNSC95FIp21pFZS660m5C_j4zd9AJ9mhnOmTNzOAi9puQDJVx9zIIKWleE6ooIySv2BE2o5KyiijVP0YQQ0lREM3KEXuS8LqMmqnmOjjjRSnEtJ-juEtrRDT4GHDvsIN16Z3vsbCg99sH5FkqL7_xw4wO2eJv8xqZ7vLj4gbNLAMGHFd76Pg4Fi2twAz6-Ol9eLL7OLufzL--KCL6KfZevx7R6j88gbWy4f4medbbP8OpQp-j76fzbbFEtz88-zz4tKycaMlSdE6JhoLQFrZXuREu441Io3grmZG3BlVloaxnjtgMhaS01aR1tgRFa8yk62etux-sNtA7CkGxvDi5MtN78jQR_Y1bx1tQNF3VNisDxQSDFnyPkwWx8dtD3NkAcs2GMEiZ5o3a33v5DXccxhWKvsJiknMvy5RTRPculmHOC7vEZSswuVrOP1ZRYzS5Ws9t586eLx41fORYC2xNygcIK0u_T_1d9AHssrYE</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2225133522</pqid></control><display><type>article</type><title>Reduction of cervical cancer incidence within a primary HPV screening pilot project (WOLPHSCREEN) in Wolfsburg, Germany</title><source>MEDLINE</source><source>SpringerLink Journals</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><source>PubMed Central</source><creator>Horn, Johannes ; Denecke, Agnieszka ; Luyten, Alexander ; Rothe, Beate ; Reinecke-Lüthge, Axel ; Mikolajczyk, Rafael ; Petry, Karl Ulrich</creator><creatorcontrib>Horn, Johannes ; Denecke, Agnieszka ; Luyten, Alexander ; Rothe, Beate ; Reinecke-Lüthge, Axel ; Mikolajczyk, Rafael ; Petry, Karl Ulrich</creatorcontrib><description>Background
Randomised controlled trials showed human papillomavirus (HPV)-based screening leads to a significant reduction in cervical cancer incidence compared with cytology-based screening only.
Methods
Non-hysterectomised participants ≥30 years underwent co-testing with Papanicolaou (Pap) smear and HR-HPV testing (Hybrid Capture 2; HC2). Women with normal findings had their next screening round after 5 years, and HC2+ and Pap abnormal cases were immediately referred for colposcopy, while cases with discordant findings had repeat testing after 12 months with referral to colposcopy in cases with persistent positive findings.
Results
Twenty-six thousand six hundred and twenty-four women were recruited between February 2006 and December 2016. Two hundred and seventy-four CIN3+ cases were diagnosed (270 HPV+, 4 HPV−), including 31 invasive cervical cancers (29 HPV+, 2 HPV−). No CIN3+ was detected in HPV− women with abnormal cytology. We observed a significant decline in the 5-year incidence of CIN3+ (from 0.96% [95% CI 0.85–1.09%] to 0.16% [95% CI 0.10–0.25%];
p
< 0.0001) and cervical cancer (from 0.10% [95% CI 0.07%–0.15%] to 0.025% [95% CI 0.01–0.08%];
p
= 0.01) between the first and subsequent rounds. Approximately 90% (246/274) of CIN3+ cases were diagnosed at first colposcopy.
Conclusions
The decline in disease rates with 5-yearly co-testing seems mainly attributable to HPV testing since no CIN3+ occurred in HPV−/Pap+ women.</description><identifier>ISSN: 0007-0920</identifier><identifier>EISSN: 1532-1827</identifier><identifier>DOI: 10.1038/s41416-019-0453-2</identifier><identifier>PMID: 30988395</identifier><language>eng</language><publisher>London: Nature Publishing Group UK</publisher><subject>631/326/596/2560 ; 631/67/1517/1371 ; 692/4028/67/2322 ; Adult ; Biomedical and Life Sciences ; Biomedicine ; Cancer Research ; Cellular biology ; Cervical cancer ; Cervix ; Cervix Uteri - virology ; Colposcopy ; Cytology ; Drug Resistance ; Early Detection of Cancer ; Epidemiology ; Female ; Germany ; Health risk assessment ; Human papillomavirus ; Humans ; Incidence ; Invasiveness ; Medical screening ; Middle Aged ; Molecular Medicine ; Oncology ; Papanicolaou Test ; Papillomaviridae - isolation & purification ; Papillomaviridae - pathogenicity ; Papillomavirus Infections - diagnosis ; Papillomavirus Infections - epidemiology ; Papillomavirus Infections - pathology ; Papillomavirus Infections - virology ; Pregnancy ; Uterine Cervical Neoplasms - diagnosis ; Uterine Cervical Neoplasms - epidemiology ; Uterine Cervical Neoplasms - pathology ; Uterine Cervical Neoplasms - virology ; Vaginal Smears - methods</subject><ispartof>British journal of cancer, 2019-05, Vol.120 (10), p.1015-1022</ispartof><rights>The Author(s) 2019</rights><rights>The Author(s) 2019. This work is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c470t-fc4472e89ae9989f4d03c35483d42c56aec3c349aa223afe4516590dc1de20163</citedby><cites>FETCH-LOGICAL-c470t-fc4472e89ae9989f4d03c35483d42c56aec3c349aa223afe4516590dc1de20163</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6734660/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6734660/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,724,777,781,882,27905,27906,41469,42538,51300,53772,53774</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30988395$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Horn, Johannes</creatorcontrib><creatorcontrib>Denecke, Agnieszka</creatorcontrib><creatorcontrib>Luyten, Alexander</creatorcontrib><creatorcontrib>Rothe, Beate</creatorcontrib><creatorcontrib>Reinecke-Lüthge, Axel</creatorcontrib><creatorcontrib>Mikolajczyk, Rafael</creatorcontrib><creatorcontrib>Petry, Karl Ulrich</creatorcontrib><title>Reduction of cervical cancer incidence within a primary HPV screening pilot project (WOLPHSCREEN) in Wolfsburg, Germany</title><title>British journal of cancer</title><addtitle>Br J Cancer</addtitle><addtitle>Br J Cancer</addtitle><description>Background
Randomised controlled trials showed human papillomavirus (HPV)-based screening leads to a significant reduction in cervical cancer incidence compared with cytology-based screening only.
Methods
Non-hysterectomised participants ≥30 years underwent co-testing with Papanicolaou (Pap) smear and HR-HPV testing (Hybrid Capture 2; HC2). Women with normal findings had their next screening round after 5 years, and HC2+ and Pap abnormal cases were immediately referred for colposcopy, while cases with discordant findings had repeat testing after 12 months with referral to colposcopy in cases with persistent positive findings.
Results
Twenty-six thousand six hundred and twenty-four women were recruited between February 2006 and December 2016. Two hundred and seventy-four CIN3+ cases were diagnosed (270 HPV+, 4 HPV−), including 31 invasive cervical cancers (29 HPV+, 2 HPV−). No CIN3+ was detected in HPV− women with abnormal cytology. We observed a significant decline in the 5-year incidence of CIN3+ (from 0.96% [95% CI 0.85–1.09%] to 0.16% [95% CI 0.10–0.25%];
p
< 0.0001) and cervical cancer (from 0.10% [95% CI 0.07%–0.15%] to 0.025% [95% CI 0.01–0.08%];
p
= 0.01) between the first and subsequent rounds. Approximately 90% (246/274) of CIN3+ cases were diagnosed at first colposcopy.
Conclusions
The decline in disease rates with 5-yearly co-testing seems mainly attributable to HPV testing since no CIN3+ occurred in HPV−/Pap+ women.</description><subject>631/326/596/2560</subject><subject>631/67/1517/1371</subject><subject>692/4028/67/2322</subject><subject>Adult</subject><subject>Biomedical and Life Sciences</subject><subject>Biomedicine</subject><subject>Cancer Research</subject><subject>Cellular biology</subject><subject>Cervical cancer</subject><subject>Cervix</subject><subject>Cervix Uteri - virology</subject><subject>Colposcopy</subject><subject>Cytology</subject><subject>Drug Resistance</subject><subject>Early Detection of Cancer</subject><subject>Epidemiology</subject><subject>Female</subject><subject>Germany</subject><subject>Health risk assessment</subject><subject>Human papillomavirus</subject><subject>Humans</subject><subject>Incidence</subject><subject>Invasiveness</subject><subject>Medical screening</subject><subject>Middle Aged</subject><subject>Molecular Medicine</subject><subject>Oncology</subject><subject>Papanicolaou Test</subject><subject>Papillomaviridae - isolation & purification</subject><subject>Papillomaviridae - pathogenicity</subject><subject>Papillomavirus Infections - diagnosis</subject><subject>Papillomavirus Infections - epidemiology</subject><subject>Papillomavirus Infections - pathology</subject><subject>Papillomavirus Infections - virology</subject><subject>Pregnancy</subject><subject>Uterine Cervical Neoplasms - diagnosis</subject><subject>Uterine Cervical Neoplasms - epidemiology</subject><subject>Uterine Cervical Neoplasms - pathology</subject><subject>Uterine Cervical Neoplasms - virology</subject><subject>Vaginal Smears - methods</subject><issn>0007-0920</issn><issn>1532-1827</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNp1UdtqGzEQFaWlcd1-QF-KoC8pdFtdd6WXQDFOXDBNSC95FIp21pFZS660m5C_j4zd9AJ9mhnOmTNzOAi9puQDJVx9zIIKWleE6ooIySv2BE2o5KyiijVP0YQQ0lREM3KEXuS8LqMmqnmOjjjRSnEtJ-juEtrRDT4GHDvsIN16Z3vsbCg99sH5FkqL7_xw4wO2eJv8xqZ7vLj4gbNLAMGHFd76Pg4Fi2twAz6-Ol9eLL7OLufzL--KCL6KfZevx7R6j88gbWy4f4medbbP8OpQp-j76fzbbFEtz88-zz4tKycaMlSdE6JhoLQFrZXuREu441Io3grmZG3BlVloaxnjtgMhaS01aR1tgRFa8yk62etux-sNtA7CkGxvDi5MtN78jQR_Y1bx1tQNF3VNisDxQSDFnyPkwWx8dtD3NkAcs2GMEiZ5o3a33v5DXccxhWKvsJiknMvy5RTRPculmHOC7vEZSswuVrOP1ZRYzS5Ws9t586eLx41fORYC2xNygcIK0u_T_1d9AHssrYE</recordid><startdate>20190514</startdate><enddate>20190514</enddate><creator>Horn, Johannes</creator><creator>Denecke, Agnieszka</creator><creator>Luyten, Alexander</creator><creator>Rothe, Beate</creator><creator>Reinecke-Lüthge, Axel</creator><creator>Mikolajczyk, Rafael</creator><creator>Petry, Karl Ulrich</creator><general>Nature Publishing Group UK</general><general>Nature Publishing Group</general><scope>C6C</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7TO</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FE</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AN0</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20190514</creationdate><title>Reduction of cervical cancer incidence within a primary HPV screening pilot project (WOLPHSCREEN) in Wolfsburg, Germany</title><author>Horn, Johannes ; Denecke, Agnieszka ; Luyten, Alexander ; Rothe, Beate ; Reinecke-Lüthge, Axel ; Mikolajczyk, Rafael ; Petry, Karl Ulrich</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c470t-fc4472e89ae9989f4d03c35483d42c56aec3c349aa223afe4516590dc1de20163</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>631/326/596/2560</topic><topic>631/67/1517/1371</topic><topic>692/4028/67/2322</topic><topic>Adult</topic><topic>Biomedical and Life Sciences</topic><topic>Biomedicine</topic><topic>Cancer Research</topic><topic>Cellular biology</topic><topic>Cervical cancer</topic><topic>Cervix</topic><topic>Cervix Uteri - virology</topic><topic>Colposcopy</topic><topic>Cytology</topic><topic>Drug Resistance</topic><topic>Early Detection of Cancer</topic><topic>Epidemiology</topic><topic>Female</topic><topic>Germany</topic><topic>Health risk assessment</topic><topic>Human papillomavirus</topic><topic>Humans</topic><topic>Incidence</topic><topic>Invasiveness</topic><topic>Medical screening</topic><topic>Middle Aged</topic><topic>Molecular Medicine</topic><topic>Oncology</topic><topic>Papanicolaou Test</topic><topic>Papillomaviridae - isolation & purification</topic><topic>Papillomaviridae - pathogenicity</topic><topic>Papillomavirus Infections - diagnosis</topic><topic>Papillomavirus Infections - epidemiology</topic><topic>Papillomavirus Infections - pathology</topic><topic>Papillomavirus Infections - virology</topic><topic>Pregnancy</topic><topic>Uterine Cervical Neoplasms - diagnosis</topic><topic>Uterine Cervical Neoplasms - epidemiology</topic><topic>Uterine Cervical Neoplasms - pathology</topic><topic>Uterine Cervical Neoplasms - virology</topic><topic>Vaginal Smears - methods</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Horn, Johannes</creatorcontrib><creatorcontrib>Denecke, Agnieszka</creatorcontrib><creatorcontrib>Luyten, Alexander</creatorcontrib><creatorcontrib>Rothe, Beate</creatorcontrib><creatorcontrib>Reinecke-Lüthge, Axel</creatorcontrib><creatorcontrib>Mikolajczyk, Rafael</creatorcontrib><creatorcontrib>Petry, Karl Ulrich</creatorcontrib><collection>Springer Nature OA/Free Journals</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Oncogenes and Growth Factors Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>British Nursing Database</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biological Science Database</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>British journal of cancer</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Horn, Johannes</au><au>Denecke, Agnieszka</au><au>Luyten, Alexander</au><au>Rothe, Beate</au><au>Reinecke-Lüthge, Axel</au><au>Mikolajczyk, Rafael</au><au>Petry, Karl Ulrich</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Reduction of cervical cancer incidence within a primary HPV screening pilot project (WOLPHSCREEN) in Wolfsburg, Germany</atitle><jtitle>British journal of cancer</jtitle><stitle>Br J Cancer</stitle><addtitle>Br J Cancer</addtitle><date>2019-05-14</date><risdate>2019</risdate><volume>120</volume><issue>10</issue><spage>1015</spage><epage>1022</epage><pages>1015-1022</pages><issn>0007-0920</issn><eissn>1532-1827</eissn><abstract>Background
Randomised controlled trials showed human papillomavirus (HPV)-based screening leads to a significant reduction in cervical cancer incidence compared with cytology-based screening only.
Methods
Non-hysterectomised participants ≥30 years underwent co-testing with Papanicolaou (Pap) smear and HR-HPV testing (Hybrid Capture 2; HC2). Women with normal findings had their next screening round after 5 years, and HC2+ and Pap abnormal cases were immediately referred for colposcopy, while cases with discordant findings had repeat testing after 12 months with referral to colposcopy in cases with persistent positive findings.
Results
Twenty-six thousand six hundred and twenty-four women were recruited between February 2006 and December 2016. Two hundred and seventy-four CIN3+ cases were diagnosed (270 HPV+, 4 HPV−), including 31 invasive cervical cancers (29 HPV+, 2 HPV−). No CIN3+ was detected in HPV− women with abnormal cytology. We observed a significant decline in the 5-year incidence of CIN3+ (from 0.96% [95% CI 0.85–1.09%] to 0.16% [95% CI 0.10–0.25%];
p
< 0.0001) and cervical cancer (from 0.10% [95% CI 0.07%–0.15%] to 0.025% [95% CI 0.01–0.08%];
p
= 0.01) between the first and subsequent rounds. Approximately 90% (246/274) of CIN3+ cases were diagnosed at first colposcopy.
Conclusions
The decline in disease rates with 5-yearly co-testing seems mainly attributable to HPV testing since no CIN3+ occurred in HPV−/Pap+ women.</abstract><cop>London</cop><pub>Nature Publishing Group UK</pub><pmid>30988395</pmid><doi>10.1038/s41416-019-0453-2</doi><tpages>8</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | 631/326/596/2560 631/67/1517/1371 692/4028/67/2322 Adult Biomedical and Life Sciences Biomedicine Cancer Research Cellular biology Cervical cancer Cervix Cervix Uteri - virology Colposcopy Cytology Drug Resistance Early Detection of Cancer Epidemiology Female Germany Health risk assessment Human papillomavirus Humans Incidence Invasiveness Medical screening Middle Aged Molecular Medicine Oncology Papanicolaou Test Papillomaviridae - isolation & purification Papillomaviridae - pathogenicity Papillomavirus Infections - diagnosis Papillomavirus Infections - epidemiology Papillomavirus Infections - pathology Papillomavirus Infections - virology Pregnancy Uterine Cervical Neoplasms - diagnosis Uterine Cervical Neoplasms - epidemiology Uterine Cervical Neoplasms - pathology Uterine Cervical Neoplasms - virology Vaginal Smears - methods |
| title | Reduction of cervical cancer incidence within a primary HPV screening pilot project (WOLPHSCREEN) in Wolfsburg, Germany |
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