Changes in cervical cancer incidence after three decades of screening US women less than 30 years old

Abstract

More investigation is necessary to clarify the contribution of screening to declines in the squamous cell carcinoma rate and to determine the etiology of adenocarcinoma rate increases over the last three decades in US women less than 30 years old. Because of the small number of actual observed cases, caution must be exercised in interpreting these trends.

Racial and ethnic disparities in cervical cancer incidence rates in the United States, 1992−2003

“…First, the results cover only women in regions of the U.S. with a SEER registry. It has been shown that the population covered by SEER tends to be urban and has a high relative percentage of foreign born residents [31]. Thus the population in our study may not be representative of the entire U.S. population.…”

“…Both types have been shown to be the result of persistent infection with an oncogenic type of human papillomavirus (HPV), most commonly types 16,18,31, and 45 [10]. Many of the risk factors previously associated with cervical cancer, especially factors concerning sexual behavior, are now viewed as indications of HPV infection [11].…”

Guidelines for screening and treatment of cervical disease in the adolescent

“…1 Finally, squamous cell cancer in women Ͻ21 years of age is exceedingly rare. 13 Therefore the American Cancer Society and ACOG recommend the initiation of cervical cytology no later than age 21, or 3 years after the onset of sexual activity.…”

Biological and clinical significance of NAC1 expression in cervical carcinomas: a comparative study between squamous cell carcinomas and adenocarcinomas/adenosquamous carcinomas

“…Squamous cell carcinomas comprise around 85% to 90%, whereas adenocarcinomas/adenosquamous carcinomas comprise 10% to 25% of cases [2,3]. Adenocarcinomas/adenosquamous carcinomas are increasing both in terms of the absolute number of cases and in the relative percentage of invasive cervical tumors diagnosed [2,3]. The incidence of adenocarcinomas/ adenosquamous carcinomas is also increasing among younger women [4].…”

“…In cervical carcinomas, and squamous cell carcinomas in particular, proto-oncogenes such as EGFR (7q12), MYC (8q24), ERBB2 (17q11. [2][3][4][5][6][7][8][9][10][11][12], CCND1 (11q13), HRAS (11q15.5), and cIAP1 (11q22) are often activated by amplification [6][7][8][9][10][11]. Some of these genes are clearly associated with malignant phenotypes [6,8,11]; however, the known oncogenes are a subset of the genes present in the amplified regions.…”