The changing trends of uterine cancer and cytology. A study of morbidity and mortality trends over a twenty year period

Abstract

Data on squamous carcinoma of the cervix from a 20 year study period (1955 to 1974) in metropolitan Toledo revealed a 66% reduction of the average annual age-adjusted incidence rate and a 61% reduction in death rate of cervical squamous carcinoma when the first time period (1955 to 1958) was compared with the last time period (1971 to 1974). The decrease for both morbidity and mortality rates was more pronounced in women age 50 years and younger. The age-adjusted death rate during this study period revealed 15.5/100,000 for black women and 8.7/100,000 for white women. The reduction in death rate of 83% in black women is more prominent than 54.5% in white women. The decrease in both morbidity and mortality for cervical squamous carcinoma has a close relation to cytologic screening activity. The factors of age and race, probably related to socioeconomic status, are two known determinants of risk for cervical squamous carcinoma. Data for endometrial carcinoma during this study period revealed 15.5/100,000 women in the average age-adjusted incidence and an increase of 13.8% in average yearly rates when the first time period (1955 to 1958) were compared with the last time period (1971 to 1974). The peak age was 60 to 64 years old in the first time period and shifted to 70 to 74 years old in the last time period. The trend in metropolitan Toledo is comparable to that of Louisville, Kentucky. The mass cytologic screening program which contributed to a remarkable reduction in morbidity and mortality for the cervical squamous carcinoma, did not have any beneficial effect on endometrial carcinoma.

Cervical cancer screening

“…Population-based screening was introduced in the United States in the mid-20th century [53,54]. Since that time, the incidence of ICC has fallen nearly 70% from rates reported in 1930, when cervical cancer ranked first among causes of malignancy-related deaths for US women [1,[53][54][55].…”

“…Since that time, the incidence of ICC has fallen nearly 70% from rates reported in 1930, when cervical cancer ranked first among causes of malignancy-related deaths for US women [1,[53][54][55]. Both occurence of the disease and death from cervical cancer are even more rare in US women today than they were in 1930.…”

Anal Cancer Screening: Barriers and Facilitators Among Ethnically Diverse Gay, Bisexual, Transgender, and Other Men Who Have Sex With Men

“…The Pap test was developed nearly 100 years ago by George Papanicolaou to show the atypical nuclear characteristics of abnormal cells: nuclear darkening (hyperchromasia), enlargement, and atypical shapes, including “raisinoid” appearance, and abnormal numbers of chromosomes (Papanicolaou, 1928, 1954). Since 1930, the Pap test is credited with detecting treatable cervical cell abnormalities before cancer, thereby reducing the incidence of cervical malignancy by 70% (American Cancer Society, 2003; Christopherson & Scott, 1977; Kim et al, 1978). Pap testing can be used similarly to examine anal cell samples to diagnose mild abnormalities, sometimes called dysplasias or atypias, and malignant changes.…”

Situação atual da detecção precoce do câncer cérvico-uterino no Brasil

“…O Registro Nacional de Patologia Tumoral, que reuniu resultados de cerca de 370.000 exames histopatológi-cos realizados no país entre 1976 e 1980, revelou que o carcinoma cérvico-uterino contribuiu com 23,7% de todos os diagnósticos realizados no sexo feminino 3 . A relevância do problema torna-se mais expressiva ao se considerar que programas de screening, através da citologia vaginal, têm-se demonstrado efetivos na redução da incidência e mortalidade por câncer cérvico-uterino em países europeus, nos EUA e Canadá 4,7,8,10,11,12 . O conhecimento sobre a historia natural dessa neoplasia permitiu identificar que seu desenvolvimento progressivo dura, em média, 10 a 20 anos.…”