Cervical cancer Screening is a routine procedure, but in rare cases medical complications can occur. A new study found that women diagnosed with invasive malignancies were at increased risk of iatrogenic injury compared to women with normal results.
Swedish researchers have analyzed data on more than 3 million women screened for cervical cancer. They found that 42 iatrogenic injuries that required hospitalization for at least two days occurred during a diagnostic test for a woman who underwent an abnormal screening test. “Cervical cancer screening is one of the most successful cancer prevention programs … According to our study, women with invasive cervical cancer have very low levels of diagnostic precision. I experienced medical complications and psychological stress during the test, “commented the corresponding author, Qing Shen. , PhD, from the Faculty of Medical Epidemiology and Biostatistics at the Karolinska Institute in Stockholm, Sweden.
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“The diagnostic assessment of cervical cancer can lead to injuries,” said Kesia, head of perinatal services at the Lincoln Medical and Mental Health Center of the New York City Health Hospital System, who was not involved in the study. Dr. Geyser commented.
“Given the fact that angiogenesis occurs in cancer, a large biopsy in such a situation can lead to hematoma or excessive blood loss. It rarely happens, but it is most certainly possible.” Said Gaiter.
In addition, Cathy Popadiuk, MD and FRCS, associate professors of obstetrics and gynecology at Memorial University of Newfoundland in St. John’s, Canada, said the findings reflect real-world and North American experiences. It was. ..
“There are certainly rare bad things that can happen during a diagnostic test of an abnormal Papanicolaou smear. Usually this is related to other things, such as actual cancer or uterine fibroids that may bleed and be in the cervix. Is related to the disease, “she said. Medscape Medical News.. “And definitely, if no cancer is detected, this can bleed and requires blood transfusions and hospitalization.”
Popadiuk pointed out that Sweden could allow patients to be hospitalized more generously, but in North America “we are moving away from inpatient care.” “I don’t think anything bad will happen in the clinic when I’m getting these relatively minor steps,” she added.
Women can be anxious, and she said hospitalization is the easiest way to arrange care, such as blood transfusions and bleeding observations. In addition, vaginal packing may be required to control bleeding, “with vaginal packing, women cannot urinate, require a Foley catheter, and cannot be easily managed at home. “She explained. “After the bleeding has subsided, the vaginal pack is often removed the next day.” This may be the reason some women are hospitalized.
Increased risk of injury
In a previous study, Shen and colleagues found an increased risk of injury during the period before and after the diagnosis of cancer ().BMJ. 2016; 354: i4218). These findings suggested that the interval between the initial suspicion of cancer and the onset of diagnosis or treatment may be a time of high risk of injury in cancer treatment.
In this latest study, they evaluated whether there was a similar increase in injury risk among patients screened for cervical cancer.Using the Swedish Total Population Register, they identified 3,016,307 women experienced Cervical screening During the period from 2001 to 2012.
The final analysis included 1,853,510 women. Papanicolaou stain specimen The result was normal. 22,435 women diagnosed with cervical intraepithelial neoplasia (CIN). 20,692 women with CIN2. 36,542 women with CIN3 or adenocarcinoma in situ (AIS). 5189 women with invasive cervical cancer.
The team found that among women who underwent abnormal screening tests, 42 iatrogenic injuries that required hospitalization for at least two days occurred. Women at greatest risk were diagnosed with invasive cancer. The risk was also increased among women diagnosed with CIN3 / AIS, but not among women with lower CIN grades.
The most common types of iatrogenic injuries were bleeding or hematomas and infections. Among all women’s groups, the incidence of injuries caused by medical procedures and care was higher than the incidence of injuries caused by drugs and biological substances.
A total of 91 non-paroxysmal injuries were identified that required at least one day of hospitalization. Women with invasive cervical cancer had an increased risk, but women with other cervical cancers did not. The most common type of non-paroxysmal injury was an unintended injury.
This study was sponsored by the Swedish Cancer Society and the Swedish Health, Working Life and Welfare Research Council. One author received the Karolinska Institute’s Principal Investigator Award and the Epidemiology Strategic Research Area Award, and one author received a grant from the China Scholarship Council. Shen does not disclose the relevant financial relationship. As a member of the OncoSim Initiative, Popadiuk receives personal fees and non-financial support from the Canadian Partnership Against Cancer...
Cancer epidemiol biomarker November 2020; 29: 2230–2234. Overview
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