TY - JOUR
T1 - Screening history of cervical cancers in Emilia-Romagna, Italy
T2 - Defining priorities to improve cervical cancer screening
AU - Rossi, Paolo Giorgi
AU - Caroli, Stefania
AU - Mancini, Silvia
AU - De Bianchi, Priscilla Sassoli
AU - Finarelli, Alba C.
AU - Naldoni, Carlo
AU - Bucchi, Lauro
AU - Falcini, Fabio
PY - 2015
Y1 - 2015
N2 - Most invasive cervical cancers in industrialized countries are due to the lack of Pap test coverage, very few are due to screening failures. This study aimed at quantifying the proportion of invasive cancers occurring in nonscreened or underscreened women and that in women with a previous negative screening, that is, screening failure, during the first two screening rounds (1996-2002) and in the following rounds (2003-2008) in the Emilia-Romagna region. All cases of invasive cancers registered in the regional cancer registry between 1996 and 2008 were classified according to screening history through a record linkage with the screening programme registry. The incidence significantly decreased from 11.6/100 000 to 8.7/100 000; this decrease is due to a reduction in squamous cell cancers (annual percentage change -6.2; confidence interval: - 7.8, -4.6) and advanced cancers (annual percentage change -6.6; confidence interval: - 8.8, -4.3), whereas adenocarcinomas and microinvasive cancers were essentially stable. The proportion of cancers among women not yet invited and among nonresponders decreased over the two periods, from 45.5 to 33.3%. In contrast, the proportion of women with a previous negative Pap test less than 5 years and 5 years or more before cancer incidence increased from 5.7 to 13.3% and from 0.3 to 5.5%, respectively. Although nonattendance of the screening programme remains the main barrier to cervical cancer control, the introduction of a more sensitive test, such as the human papillomavirus DNA test, could significantly reduce the burden of disease.
AB - Most invasive cervical cancers in industrialized countries are due to the lack of Pap test coverage, very few are due to screening failures. This study aimed at quantifying the proportion of invasive cancers occurring in nonscreened or underscreened women and that in women with a previous negative screening, that is, screening failure, during the first two screening rounds (1996-2002) and in the following rounds (2003-2008) in the Emilia-Romagna region. All cases of invasive cancers registered in the regional cancer registry between 1996 and 2008 were classified according to screening history through a record linkage with the screening programme registry. The incidence significantly decreased from 11.6/100 000 to 8.7/100 000; this decrease is due to a reduction in squamous cell cancers (annual percentage change -6.2; confidence interval: - 7.8, -4.6) and advanced cancers (annual percentage change -6.6; confidence interval: - 8.8, -4.3), whereas adenocarcinomas and microinvasive cancers were essentially stable. The proportion of cancers among women not yet invited and among nonresponders decreased over the two periods, from 45.5 to 33.3%. In contrast, the proportion of women with a previous negative Pap test less than 5 years and 5 years or more before cancer incidence increased from 5.7 to 13.3% and from 0.3 to 5.5%, respectively. Although nonattendance of the screening programme remains the main barrier to cervical cancer control, the introduction of a more sensitive test, such as the human papillomavirus DNA test, could significantly reduce the burden of disease.
KW - Cervical cancer
KW - Human papillomavirus DNA test
KW - Incidence trend
KW - Mass screening
KW - Pap test
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U2 - 10.1097/CEJ.0000000000000035
DO - 10.1097/CEJ.0000000000000035
M3 - Article
C2 - 24787379
AN - SCOPUS:84927694805
VL - 24
SP - 128
EP - 134
JO - European Journal of Cancer Prevention
JF - European Journal of Cancer Prevention
SN - 0959-8278
IS - 2
ER -