Ane Cecilie Munk

• Aasbø, Gunvor; Trope, Ameli; Nygård, Mari; Christiansen, Irene Kraus; Baasland, Ingrid & Iversen, Grete Alræk [Show all 13 contributors for this article] (2022). HPV self-sampling among long-term non-attenders to cervical cancer screening in Norway: a pragmatic randomised controlled trial. British Journal of Cancer. ISSN 0007-0920. 127(10), p. 1816–1826. doi: 10.1038/s41416-022-01954-9. Full text in Research Archive Show summary

  Background Cervical cancer screening participation is suboptimal in most settings. We assessed whether human papillomavirus (HPV) self-sampling may increase screening participation among long-term non-attenders in Norway. Methods A pragmatic randomised controlled trial with participation as the primary outcome was initiated in the national cervical screening programme in March 2019. A random sample of 6000 women aged 35–69 years who had not attended screening for at least 10 years were randomised 1:1:1 to receive either (i) a reminder to attend regular screening (control), (ii) an offer to order a self-sampling kit (opt-in) for HPV testing or (iii) a self-sampling kit unsolicited (send-to-all) for HPV testing. Results Total participation was 4.8%, 17.0% and 27.7% among control, opt-in and send-to-all (P < 0.0001; participation difference (%) send-to-all vs. control: 22.9 (95%CI: 20.7, 25.2); opt-in vs. control: 12.3 (95%CI: 10.3, 14.2); send-to-all vs. opt-in: 10.7 (95% CI: 8.0, 13.3)). High-risk HPV was detected in 11.5% of self-samples and 9.2% of clinician-collected samples (P = 0.40). Most women (92.5%) who returned a positive self-sample attended the clinic for triage testing. Of the 933 women screened, 33 (3.5%) had CIN2 + (1.1%, 3.7%, 3.8% among control, opt-in, and send-to-all, respectively), and 11 (1.2%) had cervical cancer (0%, 1.2%, 1.3% among control, opt-in, send-to-all, respectively). Conclusion Opt-in and send-to-all self-sampling increased screening participation among long-term, higher-risk non-attenders.

• Øvestad, Irene Tveiterås; Engesæter, Birgit Øvstebø; Halle, Mari Kyllesø; Akbari, Saleha; Bicskei, Beatrix & Lapin, Morten [Show all 13 contributors for this article] (2021). High-Grade Cervical Intraepithelial Neoplasia (CIN) Associates with Increased Proliferation and Attenuated Immune Signaling. International Journal of Molecular Sciences. ISSN 1661-6596. 23. doi: 10.3390/ijms23010373. Full text in Research Archive
• Halle, Mari Kyllesø; Munk, Ane Cecilie Dæhli; Engesæter, Birgit Øvstebø; Akbari, Saleha; Frafjord, Astri & Høivik, Erling Andre [Show all 15 contributors for this article] (2021). A gene signature identifying CIN3 regression and cervical cancer survival. Cancers. ISSN 2072-6694. 13(22), p. 1–18. doi: 10.3390/cancers13225737.
• Munk, Ane Cecilie Dæhli; Sagedal, Linda Reme; Krogedal, Turid Stavseth; McFadzean, Ida & Oommen, Hanna (2020). Fødende risikopasient med covid-19. Tidsskrift for Den norske legeforening. ISSN 0029-2001. 140(11), p. 1–4. doi: 10.4045/tidsskr.20.0425.
• Munk, Ane Cecilie Dæhli; Gudlaugsson, Einar; Øvestad, Irene Tveiterås; Løvslett, Kjell Ivar; Fiane, Bent & Van Diermen, Bianca [Show all 10 contributors for this article] (2012). Interaction of epithelial biomarkers, local immune response and condom use in cervical intraepithelial neoplasia 2-3 regression. Gynecologic Oncology. ISSN 0090-8258. 127(3), p. 489–494. doi: 10.1016/j.ygyno.2012.09.010.
• Munk, Ane Cecilie Dæhli; Gudlaugsson, Einar; Malpica, Anais; Fiane, Bent; Løvslett, Kjell Ivar & Kruse, Arnold-Jan [Show all 10 contributors for this article] (2012). Consistent condom use increases the regression rate of cervical intraepithelial neoplasia 2-3. PLOS ONE. ISSN 1932-6203. 7(9:e45114). doi: 10.1371/journal.pone.0045114.
• Munk, Ane Cecilie Dæhli; Øvestad, Irene Tveiterås; Gudlaugsson, Einar; Løvslett, Kjell Ivar; Fiane, Bent & Van Diermen, Bianca [Show all 10 contributors for this article] (2012). Consistent condom use increases spontaneous regression in high-risk non-HPV16 but not in HPV16 CIN2-3 lesions, a prospective population-based cohort study. Infectious Agents and Cancer. ISSN 1750-9378. 7(November 2012). doi: 10.1186/1750-9378-7-30. Show summary

  BACKGROUND: The major cause of cervical intraepithelial neoplasia (CIN) is persistent infection with human papillomavirus (HPV). Most CIN grade 2 and 3 lesions are treated with cone excision, although a substantial proportion (6-50%) of CIN2-3 lesions will regresses spontaneously. Predictors for regression of CIN2-3 are desirable in order to reduce this overtreatment. METHODS: In this prospective cohort study, 145 consecutive women with first-time onset CIN2-3 in colposcopy-directed biopsies and standardized biopsy-cone excision interval were included. The genotype of the high-risk human papillomaviruses (=hrHPV) and clinical factors including sexual behaviour, parity, contraception and smoking were assessed. Patients were divided into two groups according to lesions containing HPV16 (hrHPV16+) and high-risk non-HPV16 (hrHPV16-) genotypes. RESULTS: Women whose partners consistently used condoms showed a significantly higher regression rate than women using other types of contraception (53% versus 13%, p<0.0001). However, this effect was only seen in hrHPV16- patients (73% regression rate versus 13%, p<0.0001). HrHPV16+ patients had a significantly higher number of sexual partners and more current smokers compared to hrHPV16- patients. The regression rate was not significantly different in CIN2-3 lesions containing HPV16 (hrHPV16+) versus hrHPV16- genotypes. CONCLUSIONS: Heterogeneity among hrHPV genotypes excists. HPV-genotype analyses can identify women who significantly increase their chance of regression by consistent condom use.

• Uleberg, Kai-Erik; Munk, Ane Cecilie Dæhli; Skaland, Ivar; Furlan, Cristina; Van Diermen, Bianca & Gudlaugsson, Einar [Show all 11 contributors for this article] (2011). A protein profile study to discriminate CIN lesions from normal cervical epithelium. Cellular Oncology. ISSN 1570-5870. 34(5), p. 443–450. doi: 10.1007/s13402-011-0047-3.
• Øvestad, Irene Tveiterås; Vennestrøm, Undis; Andersen, Liv; Gudlaugsson, Einar; Munk, Ane Cecilie Dæhli & Malpica, Anais [Show all 10 contributors for this article] (2011). Comparison of different commercial methods for HPV detection in follow-up cytology after ASCUS/LSIL, prediction of CIN2-3 in follow up biopsies and spontaneous regression of CIN2-3. Gynecologic Oncology. ISSN 0090-8258. 123(2), p. 278–283. doi: 10.1016/j.ygyno.2011.07.024.
• Uleberg, Kai-Erik; Munk, Ane Cecilie Dæhli; Brede, Cato; Gudlaugsson, Einar; Van Diermen, Bianca & Skaland, Ivar [Show all 10 contributors for this article] (2011). Discrimination of grade 2 and 3 cervical intraepithelial neoplasia by means of analysis of water soluble proteins recovered from cervical biopsies. Proteome Science. ISSN 1477-5956. 9. doi: 10.1186/1477-5956-9-36.
• Øvestad, Irene Tveiterås; Gudlaugsson, Einar; Skaland, Ivar; Malpica, Anais; Munk, Ane Cecilie Dæhli & Janssen, Emilius Adrianus Maria [Show all 7 contributors for this article] (2011). The impact of epithelial biomarkers, local immune response and human papillomavirus genotype in the regression of cervical intraepithelial neoplasia grades 2-3. Journal of Clinical Pathology. ISSN 0021-9746. 64(4), p. 303–307. doi: 10.1136/jcp.2010.083626.
• Kruse, Arnold-Jan; Skaland, Ivar; Munk, Ane Cecilie; Janssen, Emilius Adrianus Maria; Gudlaugsson, Einar & Baak, Jan P.A. (2008). Low p53 and retinoblastoma protein expression in cervical intraepithelial neoplasia grade 3 lesions is associated with coexistent adenocarcinoma in situ. Human Pathology. ISSN 0046-8177. 39(4), p. 573–578. doi: 10.1016/j.humpath.2007.08.014.

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• Baasland, Ingrid; Munk, Ane Cecilie Dæhli; Tropé, Ameli Ellen Claesdotter; Dahl, Gunn Fallås; Lie, Kathrine & Barbero, Mark Lewis B Barbero [Show all 9 contributors for this article] (2023). Premaligne lidelser i cervix, Gynekologisk kreft- handlingsprogram, Helsedirektoratet.
• Nygård, Mari; Burger, Emily Annika; Nygård, Ståle; Tropé, Ameli; Falkenthal, Thea Eline Hetland & Mohr Berland, Jannicke [Show all 10 contributors for this article] (2023). Skal vi screene og konisere inn i evigheten – eller bytte HPV-vaksine? dagensmedisin.no. Show summary

  Norge blir ikke det første landet som eliminerer livmorhalskreft – til det er vi ikke ambisiøse nok, tidlig nok. Men vi kan fortsatt innrette oss bedre for å forebygge enda mer – og mer kostnadseffektivt.

• Dahl, Gunn Fallås; Berland, Jannicke; Trope, Ameli; Baasland, Ingrid; Munk, Ane Cecilie Dæhli & Trogstad, Lill (2021). Premaligne lidelser i cervix uteri, Nasjonalt handlingsprogram med retningslinjer for gynekologisk kreft. Nasjonal faglig retningslinje. Helsedirektoratet. ISSN 978-82-8081-642-9. p. 118–132.
• Munk, Ane Cecilie Dæhli (2012). Molecular biomarkers, human papillomavirus-genotypes and clinical factors in regression prediction of cervical intraepithelial neoplasia grades 2-3. Universitetet i Bergen. ISSN 978-82-308-2139-8.

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