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Martin Vessey

Publications and source records attributed to Martin Vessey.

5 recordsLinked to original sources
PubMed2006

Effect of testing for human papillomavirus as a triage during screening for cervical cancer: observational before and after study.

OBJECTIVE: To assess the effect of introducing testing for human papillomavirus combined with liquid based cytology in women with low grade cytological abnormalities. DESIGN: Observational before and after study. SETTING: Three cervical screening laboratories, England. PARTICIPANTS: 5654 women aged 20-64 with low grade cytological abnormalities found at routine cervical screening in a pilot; 5254 similar women in the period before the pilot. INTERVENTIONS: Human papillomavirus testing combined with liquid based cytology in the management of women with borderline or mildly dyskaryotic cervical smear results compared with conventional smear tests, with immediate referral to colposcopy of women positive for human papillomavirus. RESULTS: 57.9% (3187/5506) of women tested in the pilot were positive for human papillomavirus. The rate of repeat smears fell by 74%, but the rate of referral to colposcopy for low grade cytological abnormalities more than doubled. The estimated negative predictive value of human papillomavirus testing varied between 93.8% and 99.7%. CONCLUSION: The addition of testing for human papillomavirus in women with low grade cytological abnormalities resulted in a reduction in the rate of repeat smears, but an increase in rates of referral to colposcopy.

Adult↗
PubMed2003

Mortality in relation to oral contraceptive use and cigarette smoking.

BACKGROUND: As part of the Oxford Family Planning Association study, we compared mortality in relation to oral contraceptive use and smoking to highlight the differences between them from the perspective of public health. METHODS: The study consisted of 17032 women, aged 25-39 years at entry, recruited between May 1, 1968, and July 31, 1974, who had used oral contraceptives, a diaphragm, or an intrauterine device. We assessed mortality from follow-up data recorded until Dec 31, 2000. The analysis is based on woman-years of observation. FINDINGS: We analysed 889 deaths. Women who had ever used oral contraceptives had increased mortality from cervical cancer (rate ratio 7.2, 95% CI 1.1-303), and decreased mortality from other uterine (0.2, 0.0-0.8) and ovarian cancers (0.4, 0.2-0.7). Oral contraceptives had some adverse effect on deaths from ischaemic heart disease in women who smoked 15 or more cigarettes per day. For all causes of mortality, the rate ratio for death in women who ever used oral contraceptives was 0.89 (95% CI 0.77-1.02). By contrast, this rate ratio was 1.24 (1.03-1.49) in those who smoked one to 14 cigarettes per day, and 2.14 (1.81-2.53) in those who smoked 15 or more cigarettes per day. INTERPRETATION: There was no harmful effect of oral contraceptive use on overall mortality. By contrast, death from all causes was more than twice as high in smokers of 15 or more cigarettes a day as in non-smokers. The harmful effect was already apparent in women aged 35-44 years.

Adult↗
PubMed2002

Oral contraception and epilepsy: findings in a large cohort study.

There is no good evidence that oral contraceptives (OCs) increase the risk of epilepsy in unaffected women or increase the frequency of seizures in those suffering from the disorder. Nonetheless, manufacturers' literature continues to include warnings about OCs and epilepsy. We have analyzed the available data about epilepsy in the Oxford-Family Planning Association contraceptive study that includes 17,032 women followed for periods of up to 26 years. In total, 82 women (with no record of having suffered epilepsy when recruited to the study) were referred to hospital for diagnosis or treatment of epilepsy during the follow-up period. No association was found between OC use and the occurrence of the condition. Referral to hospital was, however, more frequent in women of low social class and in those with a high body mass index.

Adult↗
PubMed2002

Contraception and unexplained abdominal pain.

OBJECTIVE: To test the hypothesis that hospital referral for unexplained abdominal pain might occur less frequently in oral contraceptive (OC) users and more frequently in intrauterine device (IUD) users than in other women. DESIGN: Prospective cohort study of 17 032 women using different methods of contraception [the Oxford-Family Planning Association (FPA) contraceptive study]. OUTCOME MEASURE: Referral to hospital for unexplained abdominal pain (including pelvic pain) coded to ICD rubric 785.5 in the 8th Revision of the ICD. RESULTS: Referral was decreased by 13% (95% CI 0%-25%) in current or recent users of OCs in comparison with non-users, a difference that just reached statistical significance. No significant difference was found in the corresponding analysis for IUD users. Past users of OCs had much the same risk of referral as non-users, but the risk of referral in past users of an IUD was increased at all intervals examined, varying from 17% (95% CI -14%-55%) 13-24 months after discontinuation to 56% (95% CI 15%-107%) 73-96 months after discontinuation. Referral was 29% (95% CI 11%-50%) higher in smokers of 15 or more cigarettes a day than in non-smokers. CONCLUSION: Referral to hospital for unexplained abdominal pain may be slightly reduced in current or recent OC users and moderately increased in past IUD users. The types of IUD used most commonly in the Oxford-FPA study are, however, no longer in current use today. Hospital referral for unexplained abdominal pain seems to be moderately increased in heavy cigarette smokers.

Abdominal Pain↗