Invasive Cervical Cancer Incidence and Mortality Among Canadian Women Aged 15 to 29 and the Impact of Screening

Popadiuk, Catherine; Stankiewicz, A; Dickinson, James A; Pogany, Lisa; Miller, Anthony B.; Onysko, Jay

doi:10.1016/s1701-2163(16)35464-0

Cited by 17 publications

(19 citation statements)

References 15 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…25 In Canada, a study investigated the incidence of cervical neoplasia among 15-to 29-year-old women between 1970 and 2007, and reported a declining trend during this period, mainly with regards to squamous cell carcinomas. 26 They also found an extremely low incidence of adenocarcinomas in this population.…”

Section: Discussionmentioning

confidence: 63%

Cancer Incidence Among Adolescents and Young Adults (15 to 29 Years) in Brazil

Balmant¹,

Reis²,

Oliveira³

et al. 2016

Journal of Pediatric Hematology/Oncology

View full text Add to dashboard Cite

The spectrum of cancers commonly found in adolescents and young adults (AYAs) differs from those in children and adults; therefore, the childhood classification is not appropriate for this population. Here we used a newly proposed classification system to reclassify cases of AYAs from Brazilian population-based cancer registries (PBCRs) in 5 geographic regions of Brazil. We aimed to describe the cancer incidence rates within this age group according to PBCR. Using the world population, incidence rates per million were analyzed in each diagnostic subgroup according to sex and age at diagnosis (15 to 19 y, 20 to 24 y, and 25 to 29 y). The median incidence rate was 232.31 per million for females and 218.07 per million for males. Incidence increased with age, with the highest rate observed for 25- to 29-year-olds in both sexes. Carcinomas, lymphomas, and skin tumors were most frequent among AYAs. High incidence rates of cervix-uterus carcinoma were observed in most PBCRs. AYAs present epidemiological characteristics that differ from those of children, reinforcing the need for a new classification. This study describes, for the first time, the cancer incidence rate in AYAs in Brazil, and we believe that our findings represent the Brazilian profile.

show abstract

Section: Discussionmentioning

confidence: 63%

Cancer Incidence Among Adolescents and Young Adults (15 to 29 Years) in Brazil

Balmant¹,

Reis²,

Oliveira³

et al. 2016

Journal of Pediatric Hematology/Oncology

View full text Add to dashboard Cite

show abstract

“…From the 1990s, the rate of decrease has flattened out: which may be partly due to greater difficulty in reaching some segments of the population, and partly from reaching the limit of what can be achieved with screening. Adenocarcinoma of the cervix is less amenable to cytological screening, and while this used to comprise a small fraction, as squamous carcinomas are removed, they become a larger fraction [51,52]. In addition, more rapidly growing cancers are difficult to detect by screening and to treat [16].…”

Section: Discussionmentioning

confidence: 99%

Reduced cervical cancer incidence and mortality in Canada: national data from 1932 to 2006

et al. 2012

Self Cite

View full text Add to dashboard Cite

BackgroundHigh levels of participation in cervical screening are reported in Canada from the 1970’s as a result of early uptake of the Pap smear and universal Medicare. Despite recommendations to the contrary, the programs have featured early age of initiation of screening and frequent screening intervals. Other countries have achieved successful outcomes without such features. We analyzed national data to better understand mortality and incidence trends, and their relationships to screening.MethodsThe Canadian Cancer Registry, National Cancer Incidence Reporting System, and the Canadian Vital Statistics Database were used to measure mortality and incidence rates. Cases and deaths from invasive cervical cancer were classified by 5 year age groups at diagnosis and death (15 to 19 years through to 80 to 84 years), year of diagnosis (1972 to 2006), and year of death (1932 to 2006). Probabilities of developing and dying from cervical cancer were calculated for age-specific mortality and incidence. The proportion of women reporting a timely Pap test was estimated for 1978 to 2006.ResultsCervical cancer mortality has declined steadily from a peak of 13.5 to 2.2 per 100,000 (83%,) between 1952 and 2006, and 71% between 1972 and 2006. Incidence of invasive cervical cancer has declined by 58% since 1972. These declines have occurred more among older age groups than younger. Invasive cervical cancer incidence and mortality is less in each successive birth cohort of women. Participation rates in screening are high especially in women under age 50.ConclusionsDespite increasing risk factors for cervical cancer, both incidence and mortality have declined over time, across age groups, and across birth cohorts. Earlier increasing mortality (1932 – 1950) was likely related to improved classification of cancers and the early subsequent reduction (1950 – 1970) to improved treatment. Recent improvements in incidence and mortality are likely due to high rates of screening. For women under age 30 years there are low rates of disease but lesser improvement related to screening.

show abstract

“…Women less than 30 years of age have a very low incidence of and mortality from cc 22 , but high incidences of transient hpv infection and cervical abnormalities 23 , most of which resolve with time but require ongoing colposcopy visits and investigations. Delaying screening until age 30 allows for transient lesions to regress and more problematic ones to persist until a later first screen 24,25 .…”

Section: Discussionmentioning

confidence: 99%

“…Delaying screening until age 30 allows for transient lesions to regress and more problematic ones to persist until a later first screen 24,25 . Given the prolonged natural history for hpv infection to develop into cancer 26 , delaying screening until age 30 does not significantly affect cc incidence or mortality 22 . Similarly, within the Canadian context, the HPV Focal trial in British Columbia showed that primary hpv testing starting at age 25 resulted in high rates of hpv positivity and cytologic abnormalities requiring followup in women less than 30 years of age 18 .…”

Section: Discussionmentioning

confidence: 99%