TY - JOUR
T1 - Screening patterns within organized programs and survival of Italian women with invasive cervical cancer
AU - Zucchetto, Antonella
AU - Ronco, Guglielmo
AU - Giorgi Rossi, Paolo
AU - Zappa, Marco
AU - Ferretti, Stefano
AU - Franzo, Antonella
AU - Falcini, Fabio
AU - Visioli, Carmen Beatriz
AU - Zanetti, Roberto
AU - Biavati, Patrizia
AU - La Rosa, Francesco
AU - Baracco, Susanna
AU - Federico, Massimo
AU - Campari, Cinzia
AU - De Togni, Aldo
AU - Piffer, Silvano
AU - Pannozzo, Fabio
AU - Fusco, Mario
AU - Michiara, Maria
AU - Castaing, Marine
AU - Seghini, Pietro
AU - Tisano, Francesco
AU - Serraino, Diego
PY - 2013/9
Y1 - 2013/9
N2 - Objectives: To evaluate screening patterns within organized cervical screening programs (OCSPs) and survival of women with invasive cervical cancer (ICC). Methods: A population-based study was conducted in Italian areas covered by cancer registries and OCSPs. The study included all women aged 25-65. years diagnosed with ICC between 1995 and 2008, and their screening histories within OCSPs were retrieved. Hazard ratios (HR) of death and 95% confidence intervals (CI) were computed according to screening pattern, using Cox models adjusted for age, ICC stage, and major confounders. Results: Among 3268 women with ICC, 20% were never-invited to OCSP, 36% were never-compliant with OCSP's invitation, 33% were compliant and had a screen-detected ICC within OCSP (i.e., after a positive cytology), and 11% were compliant but had a non-screen-detected ICC. Screen-detected ICCs were more frequently micro-invasive (42%) compared to non-screen-detected ones (14%). Compared to women with screen-detected ICC, the adjusted HRs of death were 1.9 (95% CI 1.5-2.4) for those never-invited, 2.0 (95% CI 1.6-2.5) for never-compliant, and 1.7 (95% CI 1.3-2.4) for compliant women having non-screen-detected ICC. Conclusion: Prolonged survival, beyond down-staging, of women with ICC detected within OCSPs in Italy, further calls for improvements of OCSPs' invitational coverage and participation.
AB - Objectives: To evaluate screening patterns within organized cervical screening programs (OCSPs) and survival of women with invasive cervical cancer (ICC). Methods: A population-based study was conducted in Italian areas covered by cancer registries and OCSPs. The study included all women aged 25-65. years diagnosed with ICC between 1995 and 2008, and their screening histories within OCSPs were retrieved. Hazard ratios (HR) of death and 95% confidence intervals (CI) were computed according to screening pattern, using Cox models adjusted for age, ICC stage, and major confounders. Results: Among 3268 women with ICC, 20% were never-invited to OCSP, 36% were never-compliant with OCSP's invitation, 33% were compliant and had a screen-detected ICC within OCSP (i.e., after a positive cytology), and 11% were compliant but had a non-screen-detected ICC. Screen-detected ICCs were more frequently micro-invasive (42%) compared to non-screen-detected ones (14%). Compared to women with screen-detected ICC, the adjusted HRs of death were 1.9 (95% CI 1.5-2.4) for those never-invited, 2.0 (95% CI 1.6-2.5) for never-compliant, and 1.7 (95% CI 1.3-2.4) for compliant women having non-screen-detected ICC. Conclusion: Prolonged survival, beyond down-staging, of women with ICC detected within OCSPs in Italy, further calls for improvements of OCSPs' invitational coverage and participation.
KW - Cervical cancer
KW - Cytology
KW - Organized screening program
KW - Screening history
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U2 - 10.1016/j.ypmed.2013.05.018
DO - 10.1016/j.ypmed.2013.05.018
M3 - Article
C2 - 23732239
AN - SCOPUS:84881609346
VL - 57
SP - 220
EP - 226
JO - Preventive Medicine
JF - Preventive Medicine
SN - 0091-7435
IS - 3
ER -