scholarly journals Impact of screening on cervical cancer incidence in England: a time trend analysis

BMJ Open ◽  
2019 ◽  
Vol 9 (1) ◽  
pp. e026292 ◽  
Author(s):  
Francesca Pesola ◽  
Peter Sasieni
Keyword(s):  
Cervical Cancer ◽  
Trend Analysis ◽  
Cancer Incidence ◽  
Cervical Screening ◽  
Hpv Vaccination ◽  
Cervical Cancer Incidence ◽  
Incidence Data ◽  
Cancer Registry Data ◽  
Current Scenario ◽  
The Impact

ObjectivesTo better model underlying trends in cervical cancer incidence so as to model past trends, to estimate the impact of cervical screening on cervical cancer rates at different ages and to obtain a counterfactual baseline under a no-screening scenario.DesignTrend analysis of cancer registry data recorded between 1971 and 2013.SettingEngland.Participants132 493 women aged 20–84 with a diagnosis of cervical cancer.Outcome measureCervical cancer incidence data were modelled using a modified age period cohort model able to capture both increased exposure to human papillomavirus (HPV) as well as changes in the age of exposure to HPV in young cohorts. Observed rates were compared with counterfactual baseline rates under a no-screening scenario to estimate the protective effect of screening.ResultsRates of cervical cancer incidence have been decreasing since the introduction of screening but are projected to increase in the future under the current scenario. Between 1988 and 2013, it was estimated that screening had prevented approximately 65 000 cancers. Moreover, in 2013, the age-standardised rate (ASR) estimated under the no-screening scenario (37.9, 95% CI 37.4 to 38.3) was threefold higher among women aged 20–84 than the observed ASR (12.8, 95% CI 12.3 to 13.3). We estimate that the age of first HPV exposure has decreased by about 1 year every decade since the early 1970s (women born in 1955 onwards).ConclusionsOur results corroborated the importance of screening in preventing cervical cancer and indicated future rates are dependent on age at HPV exposure. Estimated future rates can be used for healthcare planning while the counterfactual baseline to quantify the impact of HPV vaccination in microsimulations.

scholarly journals Estimating the Impact of Human Papillomavirus (HPV) Vaccination on HPV Prevalence and Cervical Cancer Incidence in Mali

2011 ◽  
Vol 52 (5) ◽  
pp. 641-645 ◽  
Author(s):  
L. Tracy ◽  
H. D. Gaff ◽  
C. Burgess ◽  
S. Sow ◽  
P. E. Gravitt ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Human Papillomavirus ◽  
Cancer Incidence ◽  
Hpv Vaccination ◽  
Cervical Cancer Incidence ◽  
Hpv Prevalence ◽  
The Impact

Impact of socioeconomic status and degree of ethnic isolation on cervical cancer incidence among Hispanics and Asians in California.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 5605-5605
Author(s):  
Marie-Anne Froment ◽  
Audrey Roux ◽  
Mindy C. DeRouen ◽  
Scarlett Lin Gomez ◽  
Elizabeth A. Kidd
Keyword(s):  
Cervical Cancer ◽  
Socioeconomic Status ◽  
Cancer Incidence ◽  
Pap Smear ◽  
Invasive Cervical Cancer ◽  
The United States ◽  
Asian Women ◽  
Low Ses ◽  
Cervical Cancer Incidence ◽  
The Impact

5605 Background: The incidence of cervical cancer in the United States has declined since the introduction of the pap smear. However, differences exist based on ethnicity and socioeconomic status (SES).This study aimed to evaluate the impact of nativity, neighborhood SES and enclave (degree of ethnic isolation) on the incidence of cervical cancer in California. Methods: Using data from the California Cancer Registry, comprising three of the National Cancer Institute’s Surveillance Epidemiology and End Results (SEER) program registries, information on all primary invasive cervical cancer diagnosed in California from January 1, 1990, through December 31, 2004 was obtained. We analyzed the influence of enclave, SES, and nativity on cervical cancer incidence. Results: Among the 22,189 invasive cervical cancer cases diagnosed between 1990 and 2004, 50% were non-Hispanic white (NHW), 39% Hispanic and 11% Asian women. Seventy percent (70%) of the invasive cervical cancer cases were squamous cell carcinoma (SCC), 19% were adenocarcinoma and 11% other histologies. Approximately half (51%) of patients presented with localized disease, 33% regional disease, 10% distant disease and 6% unknown. By ethnic group, US born women showed lower rates of SCC compared to foreign-born women. Seventy-six percent (76%) of invasive cervical cases were observed in high enclave neighborhoods, and seventy percent (70%) were noted in low SES neighborhoods. Hispanics living in low SES and high enclave had 12.7 times (95% CI; 11.2-14.3) higher rate of cervical cancer than those living in high SES, low enclave neighborhoods. For Asian women incidence rates were 6 times (95% CI; 4.9-7.5) higher in the low SES, high enclave neighborhoods compared to those living in high SES, low enclave neighborhoods. Conclusions: More efforts should be done to reach out to and increase pap smear screening for women living in high enclave neighborhoods to help decrease the incidence of invasive cervical cancer cases in these groups of women.

Cervical cancer incidence can increase despite HPV vaccination

2010 ◽  
Vol 10 (9) ◽  
pp. 594-595 ◽  
Author(s):  
Diane M Harper ◽  
Pekka Nieminen ◽  
Jorma Paavonen ◽  
Matti Lehtinen
Keyword(s):  
Cervical Cancer ◽  
Cancer Incidence ◽  
Hpv Vaccination ◽  
Cervical Cancer Incidence

Cost-effectiveness of HPV vaccination in the context of high cervical cancer incidence and low screening coverage

Vaccine ◽  
2017 ◽  
Vol 35 (46) ◽  
pp. 6329-6335 ◽  
Author(s):  
Triin Võrno ◽  
Katrin Lutsar ◽  
Anneli Uusküla ◽  
Lee Padrik ◽  
Terje Raud ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cost Effectiveness ◽  
Cancer Incidence ◽  
Hpv Vaccination ◽  
Cervical Cancer Incidence ◽  
Screening Coverage ◽  
High Cervical

scholarly journals Regional differences in cervical cancer incidence and associated risk behaviors among Norwegian women: a population-based study

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Bo T. Hansen ◽  
Suzanne Campbell ◽  
Mari Nygård
Keyword(s):  
Cervical Cancer ◽  
Sexual Behaviors ◽  
Cancer Incidence ◽  
Regional Differences ◽  
Cervical Screening ◽  
Population Based ◽  
Cervical Cancer Incidence ◽  
Sexually Transmitted ◽  
The North ◽  
Screening Coverage

Abstract Background Cervical cancer incidence is influenced by screening and risk factors in the population. The main risk factor for cervical cancer is sexually transmitted human papillomavirus (HPV), which is sexually transmitted and thus associated with sexual behavior. Smoking, parity and hormonal contraceptive use may also be associated with cervical cancer risk. We compared incidence, screening coverage and risk behaviors for cervical cancer between health regions in Norway. Methods We obtained data on incidence of cervical cancer among Norwegian women during 1992–2016 and data on screening coverage from the Cancer Registry of Norway. We obtained data on sexual behavior and smoking from a population-based survey of 16,575 Norwegian women who were 18–45 years old in 2005. Results Cervical cancer incidence was higher in the northern and southeastern region than in the middle and western region (range in incidence per 100,000 person-years during 1992–2016; north: 10.5 to 14.6; southeast: 9.3 to 12.9; mid: 6.8 to 9.5; west: 8.4 to 10.0). The incidence decreased modestly in the north (average annual percentage change (95% confidence interval) − 1.0 (− 1.2 to − 0.7)) and southeast (− 0.7 (− 1.0 to − 0.3)), but did not change significantly in the mid (− 0.3 (− 1.0 to 0.4)) and west (− 0.3 (− 0.6 to 0.0)). Compared to the national average, women in the north had earlier sexual debut, more partners and higher prevalence of ever having had a sexually transmitted infection (STI), while the opposite was observed among women in the west. Women in the middle and southeastern regions tended to be similar to the national average for sexual behaviors. Although less pronounced, the prevalence of smoking showed regional patterns similar to that observed for sexual behaviors, while ever-use of hormonal contraceptives and cervical screening coverage was similar between regions. Conclusions There were regional differences in cervical cancer incidence during the era of nationally organized cervical screening in Norway. To some extent, these differences corresponded to regional differences in risk behavior for cervical cancer in the Norwegian female population.

scholarly journals The Impact of Different Screening Model Structures on Cervical Cancer Incidence and Mortality Predictions: The Maximum Clinical Incidence Reduction (MCLIR) Methodology

2020 ◽  
Vol 40 (4) ◽  
pp. 474-482
Author(s):  
Inge M. C. M. de Kok ◽  
Emily A. Burger ◽  
Steffie K. Naber ◽  
Karen Canfell ◽  
James Killen ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Cancer Incidence ◽  
Model Structure ◽  
Cervical Cancer Incidence ◽  
Screening Model ◽  
Incidence And Mortality ◽  
Cancer Intervention ◽  
The Impact ◽  
Model Structures

Background. To interpret cervical cancer screening model results, we need to understand the influence of model structure and assumptions on cancer incidence and mortality predictions. Cervical cancer cases and deaths following screening can be attributed to 1) (precancerous or cancerous) disease that occurred after screening, 2) disease that was present but not screen detected, or 3) disease that was screen detected but not successfully treated. We examined the relative contributions of each of these using 4 Cancer Intervention and Surveillance Modeling Network (CISNET) models. Methods. The maximum clinical incidence reduction (MCLIR) method compares changes in the number of clinically detected cervical cancers and mortality among 4 scenarios: 1) no screening, 2) one-time perfect screening at age 45 that detects all existing disease and delivers perfect (i.e., 100% effective) treatment of all screen-detected disease, 3) one-time realistic-sensitivity cytological screening and perfect treatment of all screen-detected disease, and 4) one-time realistic-sensitivity cytological screening and realistic-effectiveness treatment of all screen-detected disease. Results. Predicted incidence reductions ranged from 55% to 74%, and mortality reduction ranged from 56% to 62% within 15 years of follow-up for scenario 4 across models. The proportion of deaths due to disease not detected by screening differed across the models (21%–35%), as did the failure of treatment (8%–16%) and disease occurring after screening (from 1%–6%). Conclusions. The MCLIR approach aids in the interpretation of variability across model results. We showed that the reasons why screening failed to prevent cancers and deaths differed between the models. This likely reflects uncertainty about unobservable model inputs and structures; the impact of this uncertainty on policy conclusions should be examined via comparing findings from different well-calibrated and validated model platforms.

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