Cervical cancer incidence in young women: a historical and geographic controlled UK regional population study

Patel, Amit; Galaal, Khadra; Burnley, Clementine; Faulkner, Kingsley; Martin-Hirsch, P; Bland, Martin; Leeson, Simon; Beer, Helen; Paranjothy, Shantini; Sasieni, Peter; Naik, Rini

doi:10.1038/bjc.2012.148

Cited by 44 publications

(36 citation statements)

References 18 publications

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“…Although the incidence of cervical carcinoma in Korean females of all ages is decreasing (APC = −4.3%) [6], the incidence of cervical carcinoma has been increasing among Korean females under 30 years of age [30]. A steady increase in cervical carcinoma in young women (20–29 years) has also been observed in England [31]. The increased incidence of cervical carcinoma among AYAs has been attributed to increases in human papillomavirus (HPV) infection [32], [33].…”

Section: Discussionmentioning

confidence: 99%

Cancer Incidence and Survival among Adolescents and Young Adults in Korea

Moon

Park

et al. 2014

PLoS ONE

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BackgroundIn Korea, cancer is the third leading cause of death among adolescents and young adults (AYAs). However, cancer incidence and survival trends among AYAs (15–29 years) have never been studied in Korea. Therefore, this study aimed to investigate the incidence and relative survival rates and their trends among AYAs in Korea.Materials and MethodsCancer incidence data from 1999–2010 were obtained from the Korea Central Cancer Registry (KCCR). Each cancer was classified into subgroups according to the National Cancer Institute Surveillance, Epidemiology, and End Results (SEER) AYA site recode. Percent distributions, age-specific incidence rates, age-standardized incidence rates per million, and annual percent changes (APCs) were calculated for AYAs according to sex. Five-year relative survival rates were estimated for cases diagnosed between 1993 and 2010 and followed up to 2011.ResultsThe age-standardized incidence rates of all cancers combined were 196.4 and 367.8 per million for males and females, respectively (male-to-female (M/F) ratio: 0.5). The age-standardized incidence rates increased from 208.7 per million in 1999 to 396.4 per million in 2010, and the APC was 6.3% (P<0.001). The five most common cancers among AYAs were thyroid carcinoma, non-Hodgkin lymphoma, stomach carcinoma, breast carcinoma, and acute myeloid leukemia. In males, the 5-year relative survival rate improved, from 46.5% in 1993–1995 to 75.9% in 2006–2010. In females, the 5-year relative survival rate also improved, from 66.7% in 1993–1995 to 89.1% in 2006–2010.ConclusionsOur study showed increases in cancer incidence and improvements in the 5-year relative survival rate among Korean AYAs. This study also provides additional data regarding temporal and geographic trends in cancer that may enhance future efforts to identify factors affecting cancer incidence and responses to treatment among AYAs.

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Section: Discussionmentioning

confidence: 99%

Cancer Incidence and Survival among Adolescents and Young Adults in Korea

Moon

Park

et al. 2014

PLoS ONE

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“…Studies of cervical cancer in women aged 20–29 in the United Kingdom are few and tend to be small (Rieck et al , 2006; Nair et al , 2007; Herbert et al , 2008; Patel et al , 2012). The combined results for all but the largest study include a total of just 18 cancers (all of which were in women offered screening from age 20 years) diagnosed at age 20–24 years.…”

Section: Discussionmentioning

confidence: 99%

“…Over 60% of cancers in these studies were stage 1A and roughly the same proportions were found to be screen detected. The largest study by Patel et al (2012) included 152 cases aged 20–29 years diagnosed over a 10-year period in the north east (NE) of England. They found a much higher proportion of cancers at age 20–24 years (26%) than found in this national study (12%).…”

Section: Discussionmentioning

confidence: 99%

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Characteristics and screening history of women diagnosed with cervical cancer aged 20–29 years

et al. 2013

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Background:There was concern that failure to screen women aged 20–24 years would increase the number of cancers or advanced cancers in women aged 20–29 years. We describe the characteristics of women diagnosed with cervical cancer in England aged 20–29 years and examine the association between the period of diagnosis, screening history and FIGO stage.Methods:We used data on 1800 women diagnosed with cervical cancer between April 2007 and March 2012 at age 20–29 from the National Audit of Invasive Cervical Cancers.Results:The majority of cancers (995, or 62% of those with known stage) were stage 1A. Cancer at age 20–24 years was rare (12% of those aged 20–29 years), when compared with age 25 (24%) and age 26–29 years (63%); however, cancers in women aged 20–24 years tended to be more advanced and were more often of a rare histological type. For 59% of women under age 30, the cervical cancer was screen detected, most of them (61%) as a result of their first screening test. A three-fold increase in the number of cancers diagnosed at age 25 years was seen since the start of the study period.Conclusion:Cervical cancer at age 20–24 years is rare. Most cancers in women under age 30 years are screen detected as microinvasive cancer.

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“…A recent increase in invasive carcinomas in women aged 25-29 years, and to a lesser extent aged 30-34 years, appears to be related to a 'cohort effect' of young women at an increased risk of the disease. 24 Most of the cancers in women aged 20-29 years were detected by cytological screening at an early stage, particularly when microinvasive (stage IA), which may partly be a result of delaying the first screening invitation to age 25. 25 Whatever the cause of the increased rates of CIN3 and cancer, primary HPV testing, as proposed in England, would be introduced in a population with a higher prevalence of disease than ever recorded before in young women: 14 273 cases of CIN3/AIS and 464 cancers were registered in women below 30 years of age in 2013.…”

Section: High Prevalence Of Cin3 and Screen-detected Cancer In Young mentioning

confidence: 99%

Primary HPV testing: a proposal for co‐testing in initial rounds of screening to optimise sensitivity of cervical cancer screening

Herbert

2016

Cytopathology

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As explained by Kitchener in a previous issue of Cytopathology (2015;26:4-6), primary human papillomavirus (HPV) testing is likely to be introduced in the UK for all women aged 25-64 years following pilot site studies already in place. This will be necessary when the prevalence of cervical cancer and its precursors declines when vaccination takes effect but there is a risk in abandoning cytology as a primary test: a risk that would be most apparent in the present unvaccinated population in which the prevalence of cervical cancer and its precursors is exceptionally high. HPV testing is more sensitive than cytology but has a significant false-negative rate that could be detrimental to a successful screening programme if introduced without cytology backup. Accurate cytology would be needed for triage and could be compromised if HPV-negative tests were excluded from examination. This article proposes a compromise: cytology and HPV co-testing for the first two screening tests to optimise the sensitivity of the test as a whole. Registrations of invasive and in situ carcinoma of the uterine cervix in England indicate that the prevalence of the disease is highest in young women in the early rounds of screening. Calculations of the likely impact on the workload of this proposal have been based on a service evaluation of 295 cytology tests received at St Thomas' Hospital, which suggests that the volume of cytology tests would be reduced by approximately 60% compared with 80% for primary HPV testing alone. This proposal should be debated openly before irrevocable changes are made to a skilled workforce.

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Cervical cancer incidence in young women: a historical and geographic controlled UK regional population study

Cited by 44 publications

References 18 publications

Cancer Incidence and Survival among Adolescents and Young Adults in Korea

Cancer Incidence and Survival among Adolescents and Young Adults in Korea

Characteristics and screening history of women diagnosed with cervical cancer aged 20–29 years

Primary HPV testing: a proposal for co‐testing in initial rounds of screening to optimise sensitivity of cervical cancer screening

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