Screening patterns within organized programs and survival of Italian women with invasive cervical cancer

Antonella Zucchetto, Guglielmo Ronco, Paolo Giorgi Rossi, Marco Zappa, Stefano Ferretti, Antonella Franzo, Fabio Falcini, Carmen Beatriz Visioli, Roberto Zanetti, Patrizia Biavati, Francesco La Rosa, Susanna Baracco, Massimo Federico, Cinzia Campari, Aldo De Togni, Silvano Piffer, Fabio Pannozzo, Mario Fusco, Maria Michiara, Marine CastaingPietro Seghini, Francesco Tisano, Diego Serraino

Research output: Contribution to journalArticle

Abstract

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.

Original languageEnglish
Pages (from-to)220-226
Number of pages7
JournalPreventive Medicine
Volume57
Issue number3
DOIs
Publication statusPublished - Sep 2013

Keywords

  • Cervical cancer
  • Cytology
  • Organized screening program
  • Screening history

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Epidemiology

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    Zucchetto, A., Ronco, G., Giorgi Rossi, P., Zappa, M., Ferretti, S., Franzo, A., Falcini, F., Visioli, C. B., Zanetti, R., Biavati, P., La Rosa, F., Baracco, S., Federico, M., Campari, C., De Togni, A., Piffer, S., Pannozzo, F., Fusco, M., Michiara, M., ... Serraino, D. (2013). Screening patterns within organized programs and survival of Italian women with invasive cervical cancer. Preventive Medicine, 57(3), 220-226. https://doi.org/10.1016/j.ypmed.2013.05.018