title: Is it rational to start population-based cervical cancer screening at or soon after age 20? Analysis of time trends in preinvasive and invasive diseases.
abstract: The effect of starting screening at age 20 in 1988 was assessed by analysing (a) the age-specific incidence and distribution of stage and histology of invasive diseases, and (b) the detection rates of histologic moderate to high-grade intraepithelial neoplasia (CIN 2-3/AIS), and 1st abnormal cytology and repeat low-grade cytology after follow-up observation. Cancer incidence increased significantly at age 25-34 after 1979 due to early stage squamous cell and adenocarcinoma. After an initial increased rate of preinvasive disease, CIN 3 decreased significantly at age 30-34 after 1988, at age 25-29 after 1993, and levelled out after 1998 at age 20-24. The rates of CIN 2 levelled out after 1998. The rates of repeat low-grade smears decreased after observation at age 20-24 by 80%. The study confirms an increasing rate of preinvasive and invasive disease among younger women and indicates the benefit of starting organised screening at 2-3 year intervals soon after age 20.
authors.affiliation: Cancer Detection Clinic, Icelandic Cancer Society, 105 Reykjavik, Iceland. kristjan@krabb.is
authors.forename: Kristjan
authors.initials: K
authors.lastname: Sigurdsson
authors.forename: Helgi
authors.initials: H
authors.lastname: Sigvaldason
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D003584:Cytological Techniques / Q000592:standards; D005260:Female; D006801:Humans; D007055:Iceland / Q000453:epidemiology; D015994:Incidence; D008403:Mass Screening / Q000458:organization & administration*; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D013997:Time Factors; D002583:Uterine Cervical Neoplasms / Q000473:pathology / Q000517:prevention & control*; D014626:Vaginal Smears / Q000592:standards; D002578:Uterine Cervical Dysplasia / Q000473:pathology / Q000517:prevention & control*