Cervical cancer epidemiology in foreign women in Northern Italy: Role of human papillomavirus prevalence in country of origin

Enza Di Felice, Stefania Caroli, Luisa Paterlini, Cinzia Campari, Sonia Prandi, Paolo Giorgi Rossi

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This study compares the incidence and treatments of cervical neoplasia in foreigners from high migration countries and Italians in the Reggio Emilia province (Northern Italy) in 2002-2009. Standardized incidence ratios (SIRs) and 95% confidence intervals (95% CI) for cervical intraepithelial neoplasia grade 3 (CIN3) and cancer were calculated for foreigners versus Italian women; foreigners were also classified according to the prevalence of human papillomavirus (HPV) in their country of origin. The proportion of hysterectomies is presented as an indicator of inappropriate surgery in CIN3 and microinvasive cancers. A higher risk was observed in women from high human papillomavirus prevalence countries (HHPVC) both for cancer and for CIN3 (SIR=4.1, 95% CI=2.2-6.9; SIR=2.0, 95% CI 1.7-2.5, respectively), whereas in those from low human papillomavirus prevalence countries (LHPVC), no difference for cancer and a lower risk for CIN3 were observed (SIR=1.0, 95% CI 0.2-2.2; SIR=0.6, 95% CI 0.4-0.8, respectively). A lower CIN3/cancer ratio was found in women from HHPVC (2.6) and in women from LHPVC (3.6) than in Italians (7.4). The percentage of hysterectomies for CIN3 or microinvasive cancers was 3.4 in foreigners and 4.7 in Italians. A higher risk of cervical cancer was found in women from HHPVC compared with Italians and women from LHPVC, suggesting a role of HPV prevalence in the country of origin in the excess risk. The CIN3/cancer ratio was lower for both women from HHPVC and women from LHPVC, also suggesting a role of low screening uptake for cervical cancer incidence in immigrants.

Original languageEnglish
Pages (from-to)223-230
Number of pages8
JournalEuropean Journal of Cancer Prevention
Issue number3
Publication statusPublished - Apr 4 2015


  • cervical cancer
  • cervical intraepithelial neoplasia grade 3
  • cervical screening programme
  • foreigners
  • surgical appropriateness

ASJC Scopus subject areas

  • Cancer Research
  • Oncology
  • Epidemiology
  • Public Health, Environmental and Occupational Health
  • Medicine(all)


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