title: Changes in cervical cancer incidence after three decades of screening US women less than 30 years old.
abstract: OBJECTIVE
  To examine incidence trends of invasive cervical carcinoma in US women less than 30 years old from 1973 to 1999 by histologic type.
  
  
  METHODS
  Incidence rates were obtained from the National Cancer Institute's Surveillance, Epidemiology and End Results (SEER) database and stratified by age and three histologic categories: all histologic types, squamous cell carcinoma, and adenocarcinoma. The estimated annual percent change was calculated by joinpoint regression to measure trends during the entire evaluation period and a recent subperiod (1985-1999). All statistical tests were two-sided.
  
  
  RESULTS
  Incidence rates of cervical carcinoma overall and squamous cell carcinoma specifically declined during 1973-1999, with estimated annual percent changes of -0.94% (95% confidence interval [CI] -1.47%, -0.41%) and -1.10% (95% CI -1.59%, -0.62%), respectively. Rates of adenocarcinoma increased (+2.90%; 95% CI 1.34%, 4.49%), though trends have been stable since 1990. All cancers were uncommon: the annual incidence per million women ranged from 8.0 to 14.3 for squamous cell carcinoma and from 0.7 to 2.7 for adenocarcinoma. For women younger than 20 years, no statistically significant changes were observed, but cancers were rare (0-3 per million women annually).
  
  
  CONCLUSIONS
  More investigation is necessary to clarify the contribution of screening to declines in the squamous cell carcinoma rate and to determine the etiology of adenocarcinoma rate increases over the last three decades in US women less than 30 years old. Because of the small number of actual observed cases, caution must be exercised in interpreting these trends.
authors.affiliation: Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, California 94122, USA. pchan@itsa.ucsf.edu
authors.forename: Pamela G
authors.initials: PG
authors.lastname: Chan
authors.forename: Hai Yen
authors.initials: HY
authors.lastname: Sung
authors.forename: George F
authors.initials: GF
authors.lastname: Sawaya
mesh_terms: D000230:Adenocarcinoma / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology / Q000517:prevention & control*; D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology / Q000517:prevention & control*; D005260:Female; D006801:Humans; D015994:Incidence; D009361:Neoplasm Invasiveness; D011159:Population Surveillance / Q000379:methods; D014481:United States / Q000453:epidemiology; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology / Q000517:prevention & control*