Trends in cancer of the cervix uteri in Sweden following cytological screening

• Trends in cervical cancer incidence following the introduction of screening have mostly been studied using cross-sectional data and not analysed separately for squamous cell cancer and adenocarcinomas. Using Swedish nationwide data on incidence and mortality, we analysed trends during more than 3 decades and fitted Poisson-based age-period-cohort models, and also investigated whether screening has reduced the incidence of adenocarcinomas of the cervix. The incidence of reported cancer in situ increased rapidly during 1958-1967. Incidence rates of squamous cell cancer, fairly stable before 1968, decreased thereafter by 4-6% yearly in women aged 40-64, with a much smaller magnitude in younger and older women. An age-cohort model indicated a stable 70-75% reduction in incidence for women born 1940 and later compared with those born around 1923. The incidence of adenocarcinomas doubled during the 35-year study period. The mortality rate increased by 3.6% before 1968 and decreased by 4.0% yearly thereafter. Although a combination of organized and opportunistic screening can reduce the incidence of squamous cell cancer substantially, the incidence of adenocarcinomas appears uninfluenced by screening.

Nyckelord

Adenocarcinoma

Age-period-cohort models

Cervical cancer

Cytological screening

Squamous cell cancer

article

cancer screening

carcinoma in situ

cytology

female

human

major clinical study

priority journal

squamous cell carcinoma

statistical model

Sweden

uterine cervix cancer

Adult

Aged

Aged

80 and over

Carcinoma

Squamous Cell

Cohort Studies

Humans

Incidence

Mass Screening

Middle Aged

Poisson Distribution

Uterine Cervical Neoplasms

Publikations- och innehållstyp

ref (ämneskategori)

art (ämneskategori)