Trends in Invasive Cervical Cancer Incidence in East Anglia from 1971 to 1993

Abstract

Objective-To study the trends in the incidence of invasive cervical cancer in East Anglia. Design-Statistical analysis ofage specific incidence rate for the period 1971-93 using East Anglian Cancer Registry data. Subjects-All cases of invasive cervical cancer registered with the East Anglian Cancer registry, diagnosed in the period 1971-93. Main outcome measures-Changing incidence of cervical cancer.Results-For the 20 years 1971-90, trends varied widely by district and by age group, with little discernible overall effect of the increasing screening activity. Since 1990, rates have fallen sharply in the age groups targeted for screening, with a reduction of 34% (95% confidence interval 26% to 42%) from that expected based on 1971-90 trends. This fall was preceded by a rapid rise in the national uptake of screening. A shift to more favourable stage at diagnosis has also occurred. Conclusion-ehanges in the organisation and management of the national screening programme introduced in 1988 and 1989 seem to have led to substantial iInprovements in effectiveness.

Decline in Cervical Cancer Incidence and Mortality in New South Wales in Relation to Control Activities (Australia)

“…Time trend analyses of cervical cancer incidence and/or mortality in relation to the introduction and intensity of cervical screening in Nordic countries such as Iceland [1,[4][5][6], Scandinavia [7], Finland [8], and in Britain [9][10][11][12][13], have indicated the success of organised cervical screening at a population level.…”

“…A meta-analysis of published case-control and cohort studies has documented the effectiveness of regular cervical screening in preventing cancer of the cervix [3]. Evidence for effectiveness of screening in populations relies on studies of time trends in cervical cancer incidence and/or mortality in relation to the introduction and intensity of cervical screening, mainly from Nordic countries (Iceland [1,[4][5][6], Scandinavia [7], Finland [8]), Britain [9][10][11][12][13] and Canada [14]; and from studies of differentials in cervical cancer incidence or mortality between populations with different dates of introduction or intensities of cervical screening [15][16][17]. Two of these latter studies [4,5] contributed to the meta-analytic evidence [3], and the remainder are later confirmation of the benefits of cervical screening.…”

The Icelandic and Nordic cervical screening programs, Trends in incidence and mortality rates through 1995

“…The screening effect will thus be indicated by the decrease in both the incidence and the mortality rates of the screened cohorts depending on the effectiveness of the screening program. A change in the incidence and in the stage distribution are earlier indicators of the effectiveness than a change in the mortality rate (3).…”

Cervical screening: time to change the policy

“…The United Kingdom, with a 3–5‐year interval, launched an organised approach in 1988 with incentives for general practitioners. This has led to a dramatic drop in invasive cancer incidence compared with the previous “unorganised” approach 20 , 21 . Thus, Australia's current two‐year interval is at the “more frequent” end of the policy range relative to other Western countries with effective programs.…”