Circannual variation in the incidence of uterine cervix cancer.
The impact of uterine cervix cancer (UCC) can be greatly reduced by regular vaginal examination and other preventive measures. With this aim, UCC screening programs had been developed and applied for several years in Mexico and elsewhere. One point still to be considered in such preventive programs is the possible circannual pattern in the morbidity or mortality of UCC. With the aim of identifying a possible circannual pattern of variation in the incidence of UCC, we analyzed the monthly totals of positive detected cases of UCC in the state of Nuevo León (Mexico) between 1978 and 1987. For eliminating bias due to the seasonal variation in the number of preventive check-ups, data were first expressed in percentage of tests done in the same month. The least-squares fit of a 1-year cosine curve to the data reveals a statistically significant circannual pattern (p = 0.013), with a maximum of relative incidence detected in February. Results indicate UCC incidence higher than the yearly average during the winter, with secondary peaks in August and November. This pattern of variation is similar if one considers separately for analysis the relative incidence of type III, IV, or V UCC (relating to cases suggesting, highly suggesting, or concluding a malignant alteration, respectively). For evaluating the cost-effectiveness of the UCC screening campaign providing these data, the monthly totals of screening check-ups done over the same period were also analyzed. Results reveal a statistically significant circannual rhythm (p < 0.001), with a maximum detected in June.(ABSTRACT TRUNCATED AT 250 WORDS)
Hermida
R C
RC
Bioengineering & Chronobiology Laboratories, E.T.S.I. Telecommunicación, University of Vigo, Spain.
Ayala
D E
DE
López-Franco
J J
JJ
Arróyave
R J
RJ
D002909:Chronobiology Phenomena; D005260:Female; D006801:Humans; D008403:Mass Screening; D008800:Mexico / Q000453:epidemiology; D012621:Seasons; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology* / Q000517:prevention & control; D014626:Vaginal Smears