Contributions and Limitations of National Cervical Cancer Screening Program in Korea: A Retrospective Observational Study

Lee, Jung Hyun; Kim, Hyeongsu; Choi, Heejung; Jeong, Hyoseon; Ko, Young Hwii; Shim, Seung‐Hyuk; Lee, Eunjoo; Chae, Su Hyun

doi:10.1016/j.anr.2017.12.002

Cited by 8 publications

(8 citation statements)

References 22 publications

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“…Contrary to this study, the incidence of cervical cancer has been decreasing in other high‐resource countries 2‐4 . This includes other East Asian countries whose success is considered to be the result of a combination of cervical cancer control measures, particularly organized cervical screening 4,32‐34 . Cervical screening with a highly sensitive and precise test has been proven to reduce the incidence and mortality of cervical cancer by increasing early detection 35‐37 .…”

Section: Discussionmentioning

confidence: 72%

Trends in cervical cancer incidence and mortality of young and middle adults in Japan

Tanaka

Palmer

Katanoda³

2022

Cancer Science

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In most high‐resource countries with organized screening programs, the incidence and mortality of cervical cancer is decreasing. Recent statistics have also revealed a reduction in invasive cervical cancer incidence as a result of national vaccination programs. Paradoxically, cervical cancer incidence has increased in Japan, particularly amongst women of reproductive age. This study aimed to examine the trends in cervical cancer incidence and mortality for young and middle adult women in Japan, by analyzing trends in 10‐year interval age‐groups. Cervical cancer incidence for young and middle adult women (ages 20‐59 years) was obtained from high‐quality population‐based cancer registries in three prefectures from 1985 to 2015. National cancer mortality data were obtained from published vital statistics from 1985 to 2019. Trends in crude and age‐standardized rates (ASR) were analyzed using Joinpoint regression. The cervical cancer incidence trend in 20‐59‐year‐old women combined significantly increased over the observation period. Both crude and ASR increased from 1985 to 2015 with an annual percent change (APC) of +1.6% (95% confidence interval, 1.1, 2.1) and +1.7% (1.2, 2.3), respectively. Similar increases were seen in ages 20‐29, 30‐39, and 40‐49 years with higher APCs especially in 20s and 30s. Both crude and ASR mortality significantly increased after the early 1990s in ages 20‐59 years combined. Based on the recognition that current cervical cancer control strategies in Japan have not been effective in reducing the cervical cancer burden in young and middle adults, promotion of screening and vaccination should be urgently strengthened.

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Section: Discussionmentioning

confidence: 72%

Trends in cervical cancer incidence and mortality of young and middle adults in Japan

Tanaka

Palmer

Katanoda³

2022

Cancer Science

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“…11 , 13 Cervical cancer can be prevented by a combination of organizational screening and human papillomavirus (HPV) vaccination. 7 , 9 , 51 , 52 In Japan, the national HPV vaccination program has been substantially halted by the fear of potential adverse effects. 53 , 54 A simulation modeling study demonstrated that rapid restoration of vaccination coverage and catch-up for missed cohorts could avoid approximately 50,000 cervical cancer cases in 50 years.…”

Section: Discussionmentioning

confidence: 99%

Updated Trends in Cancer in Japan: Incidence in 1985–2015 and Mortality in 1958–2018—A Sign of Decrease in Cancer Incidence

Katanoda¹,

Hori²,

Saito³

et al. 2021

Journal of Epidemiology

108

101

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Background Unlike many North American and European countries, Japan has observed a continuous increase in cancer incidence over the last few decades. We examined the most recent trends in population-based cancer incidence and mortality in Japan. Methods National cancer mortality data between 1958 and 2018 were obtained from published vital statistics. Cancer incidence data between 1985 and 2015 were obtained from high-quality population-based cancer registries maintained by three prefectures (Yamagata, Fukui, and Nagasaki). Trends in age-standardized rates (ASR) were examined using Joinpoint regression analysis. Results For males, all-cancer incidence increased between 1985 and 1996 (annual percent change [APC] +1.1%; 95% confidence interval [CI], 0.7–1.5%), increased again in 2000–2010 (+1.3%; 95% CI, 0.9–1.8%), and then decreased until 2015 (−1.4%; 95% CI, −2.5 to −0.3%). For females, all-cancer incidence increased until 2010 (+0.8%; 95% CI, 0.6–0.9% in 1985–2004 and +2.4%; 95% CI, 1.3–3.4% in 2004–2010), and stabilized thereafter until 2015. The post-2000 increase was mainly attributable to prostate in males and breast in females, which slowed or levelled during the first decade of the 2000s. After a sustained increase, all-cancer mortality for males decreased in 1996–2013 (−1.6%; 95% CI, −1.6 to −1.5%) and accelerated thereafter until 2018 (−2.5%; 95% CI, −2.9 to −2.0%). All-cancer mortality for females decreased intermittently throughout the observation period, with the most recent APC of −1.0% (95% CI, −1.1 to −0.9%) in 2003–2018. The recent decreases in mortality in both sexes, and in incidence in males, were mainly attributable to stomach, liver, and male lung cancers. Conclusion The ASR of all-cancer incidence began decreasing significantly in males and levelled off in females in 2010.

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“…In Korea, even though cervical cancer screening rates were low in 2002 (30.8%), they have increased gradually since then (40.9% in 2012) [ 17 ]: the lifetime screening rate of cervical cancer was much higher (74.8%) [ 18 ]. The sensitivity and specificity of Pap smear tests in 2014 were 91.2% and 97.7%, respectively [ 19 ]. We believe that the quality of the Pap smear test might have contributed to the observed effects in this study.…”

Section: Discussionmentioning

confidence: 99%

Effect of Pap smear screening on cervical cancer stage at diagnosis: results from the Korean National Cancer Screening Program

et al. 2021

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Objective We aimed to determine the differences in stage at diagnosis of cervical cancer among Korean women according to screening history. Methods Using linkage data from the Korean Central Cancer Registry and Korean National Cancer Screening Program (KNCSP), we included 18,388 women older than 30 years who were newly diagnosed with cervical cancer between 2013 and 2014 and examined their screening history. Between individuals, age group and socioeconomic status were matched to control for potential confounders. Results Significantly more cases of carcinoma in situ (CIS) were diagnosed in the ever-screened (71.77%) group than in the never-screened group (54.78%), while localized, regional, distant, and unknown stage were more frequent in the never-screened group. Women in the ever-screened group were most likely to be diagnosed with CIS than with invasive cervical cancer (adjusted odds ratio [aOR]=2.40; 95% confidence interval [CI]=2.18–2.65). The aOR for being diagnosed with CIS was highest among women who were screened 3 times or more (aOR=5.10; 95% CI=4.03–6.45). The ORs were highest for women screened within 24 months of diagnosis and tended to decrease with an increasing time since last screening (p-trend <0.01). Conclusion The KNCSP for cervical cancer was found to be positively associated with diagnosis of cervical cancers at earlier stages among women aged 30 years or older. The benefit of screening according to time was highest for women screened within 24 months of diagnosis.

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Contributions and Limitations of National Cervical Cancer Screening Program in Korea: A Retrospective Observational Study

Cited by 8 publications

References 22 publications

Trends in cervical cancer incidence and mortality of young and middle adults in Japan

Trends in cervical cancer incidence and mortality of young and middle adults in Japan

Updated Trends in Cancer in Japan: Incidence in 1985–2015 and Mortality in 1958–2018—A Sign of Decrease in Cancer Incidence

Effect of Pap smear screening on cervical cancer stage at diagnosis: results from the Korean National Cancer Screening Program

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