International incidence rates of invasive cervical cancer before cytological screening

Gustafsson, L.; Pontén, Jan; Bergström, Reinhold; Adami, Hans‐Olov

doi:10.1002/(sici)1097-0215(19970410)71:2<159::aid-ijc6>3.0.co;2-#

Cited by 291 publications

(274 citation statements)

References 12 publications

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“…This prediction is consistent with the literature where peaks are reported between 44 and 49 years for European countries 52 and lifetime risks between 2.5% and 3.7%. 12,14,15,25,41 The predicted percentage of clinical cases in FIGO stage 1 is 40% and is consistent with a reported figure of 43%.…”

Section: Discussionsupporting

confidence: 93%

See 1 more Smart Citation

Natural history and screening model for high‐risk human papillomavirus infection, neoplasia and cervical cancer in the Netherlands

Berkhof

Bruijne

Zielinski

et al. 2005

Intl Journal of Cancer

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A simulation model is presented that assumes that persistent infection with high-risk human papillomavirus (hrHPV) is a necessary cause of cervical cancer. For the estimation of the model parameters, data of recent Dutch follow-up studies were reanalyzed. The predicted incidences of cervical cancer, cervical intraepithelial neoplasia (CIN1, CIN2 and CIN3) and abnormal cytology were validated with nationwide figures and population-based screening results. The model predicted a lifetime risk for cervical cancer of 2.9% with a peak at age 48 years. The predicted lifetime risk dropped to 0.4% when attending cervical screening. For women who were not hrHPV infected at 30 years, the lifetime risk was 1.6%. Sensitivity analyses were performed to check natural history assumptions that were only weakly identified from available data sets. The incidence of CIN3 observed with screening appeared a useful clinical end point as the predicted incidence was robust against changes in the sensitivity of cervical cytology and the duration to CIN3. The model can be used to study the healtheconomic benefits that can be achieved in nationwide screening when including an hrHPV test. ' 2005 Wiley-Liss, Inc.Key words: cervical neoplasms; cytology; cost effectiveness; human papillomavirus; longitudinal studies; models; screening Population-based screening is regarded as an effective method for reducing the incidence of invasive cervical cancer. Epidemiologic studies report that in countries where cytologic screening has been implemented, the incidence of cervical cancer has shown a larger decrease than in countries without screening. 1,2 Although many countries subscribe to the necessity of screening, each country has its own screening program and different opinions about the optimal program remain.Because persistent infection with the high-risk human papillomavirus (hrHPV) is the key causative agent of cervical cancer, 3,4 many recent and ongoing longitudinal studies have examined whether a test for detection of hrHPV in addition to cytologic inspection increases the efficacy of screening. 5-9 Combined screening (hrHPV and cytology) leads to an earlier detection of women who are at risk for developing high-grade lesions 10 and has a higher sensitivity for the detection of high-grade lesions. 11 However, hrHPV testing also induces extra screening costs so that the determination of the optimal screening scenario involves an elaborate cost-effectiveness analysis.An attractive way to study the efficacy of different screening scenarios is simulation modeling. 12-16 Simulation enables us to combine the results of several studies, compare a large number of scenarios and provides an assessment of the costs and effectiveness in preventing cancer. A simulation model requires the specification of an underlying natural history model that describes health trajectories of women in an unscreened population. We present a natural history model for women in the Netherlands between 30 and 80 years of age and apply the model to predict the incidence of ne...

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Section: Discussionsupporting

confidence: 93%

“…Epidemiologic studies report that in countries where cytologic screening has been implemented, the incidence of cervical cancer has shown a larger decrease than in countries without screening. 1,2 Although many countries subscribe to the necessity of screening, each country has its own screening program and different opinions about the optimal program remain.…”

mentioning

confidence: 99%

Natural history and screening model for high‐risk human papillomavirus infection, neoplasia and cervical cancer in the Netherlands

Berkhof

Bruijne

Zielinski

et al. 2005

Intl Journal of Cancer

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“…Other studies have also shown that within Europe, The Netherlands have a very low incidence, and a very high survival compared with other countries (Levi et al, 2000). It is reasonable to attribute these findings to the presence of a nationwide screening programme, as similar effects on incidence have been described in other countries with a screening programme (Gustafsson et al, 1997). Whether the effect on survival in the absence of changes in treatment can be exclusively attributed to the cervical cancer screening programme, remains a question of debate (Quinn et al, 1999;Sasieni and Adams, 1999).…”

Section: Incidence and Survival Of Cervical Cancer S Bulk Et Almentioning

confidence: 63%

“…Population-based cervical cancer screening has led to a decrease in the incidence of cervical cancer (Gustafsson et al, 1997;Vizcaino et al, 2000). However, recent data suggest that the decrease in incidence is caused by a decrease of squamous cell carcinoma, while the incidence of adenocarcinoma of the cervix shows no change or sometimes even an increase (Anttila et al, 1999;Bergstrom et al, 1999;Hemminki et al, 2001;Liu et al, 2001).…”

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confidence: 99%

Incidence and survival rate of women with cervical cancer in the Greater Amsterdam area

et al. 2003

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To evaluate the effect of population-based cervical cancer screening on the occurrence of cervical cancer in The Netherlands, we investigated the incidence and survival of cervical cancer registered by a cancer registry in the Greater Amsterdam area. The incidence rate of squamous cell carcinoma decreased significantly from 9.2/100 000 women in 1988 to 5.9/100 000 in 2000 (Po0.001). The incidence rate of adenocarcinomas remained stable. After adjustment for age, stage and lymph node involvement, the relative risk of death was 1.6 times higher for patients with adenocarcinomas than for patients with squamous cell carcinoma (95% CI 1.2 -2.1). The decreased survival was related to histological type, as the effect remained significant after correction for confounding factors. Over time, the prognosis of women with squamous cell carcinoma improved significantly. No significant change was observed for women diagnosed with adenocarcinoma. These results suggest that the screening programme in The Netherlands as executed in the Greater Amsterdam area is associated with a decreased incidence and increased survival of patients with squamous cell carcinoma, but fails to detect (pre)malignant lesions of adenocarcinoma. Since more than 92% of adenocarcinomas and its precursors contain high-risk HPV, adding HPV testing to cytologic screening might improve the present screening programme in detecting adenocarcinoma and its precursor lesions.

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“…Women with precancerous or cancerous lesions identified through Pap screening are referred for repeat Pap screening, colposcopy, biopsy and, where appropriate, treatment. The development and implementation of population-based Pap smear screening programmes for the early detection of pre-cancerous cervical lesions, together with aggressive treatment of women with abnormal biopsies, are thought to be largely responsible for the significantly reduced incidence of and mortality from ICC seen in many developed countries since the 1950s [8,[35][36][37][38][39].…”

Section: Prevention Of Cervical Cancer Secondary Prevention : Cytologmentioning

confidence: 99%

Vaccines for cervical cancer

Lowndes¹

2006

Epidemiol. Infect.

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SUMMARYThis review focuses on current and future prevention of invasive cervical cancer (ICC), the second most common cancer among women worldwide. Implementation of population-based cytological screening programmes, using the 'Pap ' smear to detect pre-cancerous lesions in the cervix, has resulted in substantial declines in mortality and morbidity from ICC in North America and some European countries. However, cases of, and deaths from, ICC continue to occur. Primary prevention of infection with high-risk human papillomavirus (HPV) types, the central causal factor of ICC, could further reduce incidence of and mortality from ICC. This is particularly the case in developing countries, which bear 80% of the burden of ICC, and where effective Pap screening programmes are extremely difficult to implement. Very promising results from several trials of synthetic HPV type-specific monovalent (HPV 16) and bivalent (HPV 16 and 18) vaccines have recently been published, showing high efficacy against type-specific persistent HPV infection and development of type-specific pre-cancerous lesions. Large-scale phase III trials of a number of such vaccine candidates are currently underway, and there is real hope that an effective vaccine capable of protecting against infection with HPV types 16 and 18 (which together account for y70% of cervical cancer cases worldwide), and thereby of preventing development of a very significant proportion of cases of ICC, could be available within the next 2 years.

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International incidence rates of invasive cervical cancer before cytological screening

Cited by 291 publications

References 12 publications

Natural history and screening model for high‐risk human papillomavirus infection, neoplasia and cervical cancer in the Netherlands

Natural history and screening model for high‐risk human papillomavirus infection, neoplasia and cervical cancer in the Netherlands

Incidence and survival rate of women with cervical cancer in the Greater Amsterdam area

Vaccines for cervical cancer

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