The Duration of Intraepithelial and Preclinical Squamous Cell Carcinoma of the Uterine Cervix

Kashgarian, Mark; Dunn, John E.

doi:10.1093/oxfordjournals.aje.a121201

Cited by 51 publications

(20 citation statements)

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“…18,19 However, it is still not certain whether the time interval for developing invasive cancer differs among young and older women. 25,26 This study data showed that the time interval from the first peak of infection (26-30 years) to the onset of cancer (41-45 years) for the younger women was similar to their older counterpart. This corroborates with the hypothesis that the time taken from infection to the development of invasive cancer is, in general, equally slow for young and older women, although it is not possible to calculate the transit time from CIN lesion to invasive lesions based on the current data.…”

Section: Short Reportmentioning

confidence: 66%

Age distribution of human papillomavirus infection and cervical neoplasia reflects caveats of cervical screening policies

Chan

Chang

et al. 2009

Intl Journal of Cancer

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Although a second age-related peak of human papillomavirus (HPV) infection is observed in many populations, it does not seem to have any impact on cervical screening policies. We examined the age-specific prevalence of HPV infection among 2,604 women enrolled for cervical screening and correlated the age at diagnosis of 2,491 cervical intraepithelial neoplasia Grade 2/3 (CIN2/3) lesions and 801 invasive cervical cancers (ICC). Two peaks of HPV infection were detected at 26-30 and 46-50 years, respectively. The first infection peak was followed by a CIN2/3 peak and an ICC peak at 5-15 and 15 years later, respectively. The second infection peak was followed by an ICC peak 20 years later, but strikingly no CIN2/3 peak was detected in between and thus eliminated an opportunity of treating the lesions at preinvasive stages. The most plausible explanation is that women at the expected second CIN2/3 peak (50-65 years) are not having Pap smears under the current opportunistic screening program. Furthermore, women of this age may have physiological retraction of the transformation zone, and CIN lesions may remain undetected if an adequate Pap smear sample is not obtained. To combat this problem, the screening program in Hong Kong needs to focus on women aged 50 years and older and a mop-up screening up to 75 years is necessary. Bimodal peaks of HPV infection and cervical cancer are seen in many countries and the analysis of populationspecific age distribution of CIN2/3 should be an integral exercise in evaluating the effectiveness of a screening program.Human papillomavirus (HPV) infection is a necessary cause of cervical cancer. 1 The infection is mainly transmitted by the sexual route and occurs most commonly in young sexually active individuals with peak prevalence in women younger than 25 years. 2,3 Interestingly, most studies have also observed a second less pronounced peak of infection among older women, mostly 55 years and older. 2 A few hypotheses have been proposed to explain this observation. First, hormonal changes associated with menopause might induce reactivation of latent HPV infection; however, this second peak has not been universally observed in postmenopausal women. Second, it could be attributed to changes in sexual behavior of women and their partners in middle age, but the occurrence of second peak did not correlate well with data on sexual behavior. 2,3 Finally, the second peak may be a reflection of population-specific cohort effects as it is not consistently observed across the world. 2,4 The underlying reason for this second minor peak is still obscure, and its potential importance has not been fully investigated. It has been shown that a3/a15 HPV types, including HPV61, 71, 72, 81, 83, 84 and 89, are more commonly found in cervical scrape samples collected from older women and these samples also contain more squamous cells. 5 Because a3/a15 HPV types are nononcogenic, the significance of the increased prevalence among older women is unclear. 6 Nonetheless, many studies have confirmed a second ...

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Section: Short Reportmentioning

confidence: 66%

Age distribution of human papillomavirus infection and cervical neoplasia reflects caveats of cervical screening policies

Chan

Chang

et al. 2009

Intl Journal of Cancer

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“…The duration of the stage between transition from cancer in situ to invasive cancer is another controversial issue, the estimated mean duration varying from 1 to 30 years (Boyes et al, 1962;Fidler et al, 1968;Boyes & Worth, 1968;Kashgarian & Dunn, 1970;Coppleson & Brown, 1975;Canadian Task Force on Screening, 1976;Barron et al, 1978;Koss, 1979;Albert, 1981). The approach used in this study to assess this quantity has not to our knowledge been used before, but more recent analyses based on different statistical techniques (Barron et al, 1978) have often yielded estimates relatively close to those obtained here, i.e.…”

Section: Resultsmentioning

confidence: 99%

Natural history of cervical neoplasia: consistent results obtained by an identification technique

Gustafsson

Adami²

1989

Br J Cancer

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“…However, the median age of pre-invasive lesions were 34 years, while SCC stage I was 41 years, and SCC stage IV was 63 years. Many studies have been published over the last 50 years, trying to explain the wide range of the age of diagnosis, firstly giving rise to a theory of two biologically different types of cervical cancer, a slow growing one in young women and a fast growing type in older women [38] with a mean duration of the pre-invasive phase to be 16 years in women between 25 and 35, and 1 year in women above the age of 65 [21]. Later, studies which showed fast growing tumours in young women accumulated [5,8,10,23,[39][40][41][42][43][44][45][46][47][48][49][50].…”

Section: Age At Diagnosismentioning

confidence: 99%

“…However, these estimates vary between 5 and 16 years [13,[18][19][20][21][22][23][24][25]. Recent knowledge on the natural history of HPV infection, which is believed to be the initiating causal factor, indicates an even shorter duration of the pre-invasive phase [26][27][28][29][30][31].…”

Section: Introductionmentioning

confidence: 99%

Screening histories of women with CIN 2/3 compared with women diagnosed with invasive cervical cancer: a retrospective analysis of the Norwegian Coordinated Cervical Cancer Screening Program

Nygård

Skare

et al. 2005

Cancer Causes Control

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The Duration of Intraepithelial and Preclinical Squamous Cell Carcinoma of the Uterine Cervix

Cited by 51 publications

References 0 publications

Age distribution of human papillomavirus infection and cervical neoplasia reflects caveats of cervical screening policies

Age distribution of human papillomavirus infection and cervical neoplasia reflects caveats of cervical screening policies

Natural history of cervical neoplasia: consistent results obtained by an identification technique

Screening histories of women with CIN 2/3 compared with women diagnosed with invasive cervical cancer: a retrospective analysis of the Norwegian Coordinated Cervical Cancer Screening Program

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