Validation of histological diagnoses in a national cervical screening register
Validation of histological diagnoses in a national cervical screening register
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DOI：
10.3109/0284186x.2011.593547
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发表时间：
2012-01-01
期刊：
影响因子：
3.1
通讯作者：
Anttila, Ahti
中科院分区：
文献类型：
--
作者：
Lonnberg, Stefan;Leinonen, Maarit;Anttila, Ahti
背景资料。监测和评估癌症筛查方案需要关于邀请、访问、检测结果、诊断和管理的准确数据。这项研究的目的是通过将数据与癌症登记簿和医院行政出院登记簿进行比较，评估芬兰宫颈癌筛查登记簿中组织学诊断(宫颈癌前病变和癌症)的完整性和准确性。材料和方法。使用唯一的个人识别符将1998-2007年期间所有16 353次导致转诊阴道镜检查的筛查数据分别与出院和癌症登记数据联系起来。评估登记簿之间的一致性，以及筛查登记簿和出院登记簿诊断的敏感度、覆盖率和阳性预测值(PPV)。癌症登记中的浸润性病例和癌前病变的合并病例被用作参考病例群体。结果。宫颈癌筛查登记的敏感度为69%，覆盖率为100%，PPV为77%。出院登记簿的对应值分别为81%、100%和83%。宫颈上皮内瘤变2级或更严重(CIN2+)筛查登记对合并病例人群的敏感度为89%，覆盖率为99%。出院登记簿的对应值分别为78%和93%。三个登记簿之间配对一致性的Kappa值在0.73到0.79之间，筛查登记簿中的病变级别通常低于其他两个登记簿中的病变级别。结论。筛查登记册中的数据复盖率很高，因此对统计和评估目的很有用。然而，为了提高诊断信息的准确性，有理由考虑通过系统地与其他保健登记处建立联系来检索数据。
Background. Monitoring and evaluation of cancer screening programmes require accurate data on invitations, visits, test results, diagnoses and management. The purpose of this study was to evaluate the completeness and accuracy of histological diagnoses (cervical precancerous lesions and cancer) in the Finnish cervical cancer screening register by comparing data with the cancer register and the administrative hospital discharge register. Material and methods. Screening data covering all 16 353 screening episodes that resulted in a referral for colposcopy over the period of 1998-2007 were individually linked with hospital discharge and cancer register data using the unique personal identifier. Agreement between registers, as well as sensitivity, coverage and positive predictive values (PPV) for the screening register and the hospital discharge register diagnosis, were estimated. Invasive cases in the cancer register and pooled cases of precancerous lesions were used as reference case populations. Results. The sensitivity of the screening register for cervical cancer was 69%, the coverage 100% and the PPV 77%. Corresponding values for the hospital discharge register were 81%, 100% and 83%, respectively. Sensitivity of the screening register for cervical intraepithelial neoplasia grade 2 or worse (CIN2+) against the pooled case population was 89% and coverage 99%. Corresponding values for the hospital discharge register were 78% and 93%. Kappa-values for pair-wise agreement between the three registers ranged between 0.73 and 0.79, often the lesion grade was lower in the screening register than in the other two registers. Conclusions. The data in the screening register has high coverage and is thus useful for statistical and evaluation purposes. However, in order to improve the accuracy of diagnostic information, there are grounds to consider data retrieval through systematic linkage to other health care registers.