Trends in cancer of the cervix uteri in Sweden following cytological screening.
Trends in cervical cancer incidence following the introduction of screening have mostly been studied using cross-sectional data and not analysed separately for squamous cell cancer and adenocarcinomas. Using Swedish nationwide data on incidence and mortality, we analysed trends during more than 3 decades and fitted Poisson-based age-period-cohort models, and also investigated whether screening has reduced the incidence of adenocarcinomas of the cervix. The incidence of reported cancer in situ increased rapidly during 1958-1967. Incidence rates of squamous cell cancer, fairly stable before 1968, decreased thereafter by 4-6% yearly in women aged 40-64, with a much smaller magnitude in younger and older women. An age-cohort model indicated a stable 70-75% reduction in incidence for women born 1940 and later compared with those born around 1923. The incidence of adenocarcinomas doubled during the 35-year study period. The mortality rate increased by 3.6% before 1968 and decreased by 4.0% yearly thereafter. Although a combination of organized and opportunistic screening can reduce the incidence of squamous cell cancer substantially, the incidence of adenocarcinomas appears uninfluenced by screening.
Bergström
R
R
Department of Information Sciences, Uppsala University, Sweden.
Sparén
P
P
Adami
H O
HO
D000230:Adenocarcinoma / Q000453:epidemiology* / Q000401:mortality / Q000517:prevention & control; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002278:Carcinoma in Situ / Q000453:epidemiology / Q000401:mortality / Q000517:prevention & control; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology* / Q000401:mortality / Q000517:prevention & control; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015994:Incidence; D008403:Mass Screening / Q000639:trends*; D008875:Middle Aged; D016012:Poisson Distribution; D013548:Sweden / Q000453:epidemiology; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology* / Q000401:mortality / Q000517:prevention & control