Inequalities in the incidence of cervical cancer in South East England 2001-2005: an investigation of population risk factors.
BACKGROUND
The incidence of cervical cancer varies dramatically, both globally and within individual countries. The age-standardised incidence of cervical cancer was compared across primary care trusts (PCTs) in South East England, taking into account the prevalence of known behavioural risk factors, screening coverage and the deprivation of the area.


METHODS
Data on 2,231 cases diagnosed between 2001 and 2005 were extracted from the Thames Cancer Registry, and data on risk factors and screening coverage were collated from publicly available sources. Age-standardised incidence rates were calculated for each PCT using cases of squamous cell carcinoma in the screening age group (25-64 years).


RESULTS
The age-standardised incidence rate for cervical cancer in South East England was 6.7 per 100,000 population (European standard) but varied 3.1 fold between individual PCTs. Correlations between the age-standardised incidence rate and smoking prevalence, teenage conception rates, and deprivation were highly significant at the PCT level (p < 0.001). However, screening coverage was not associated with the incidence of cervical cancer at the PCT level. Poisson regression indicated that these variables were all highly correlated and could not determine the level of independent contribution at a population level.


CONCLUSIONS
There is excess disease burden within South East England. Significant public health gains can be made by reducing exposure to known risk factors at a population level.
Currin
Laura G
LG
King's College London, Thames Cancer Registry, Capital House, London, UK. laura.g.currin@kcl.ac.uk
Jack
Ruth H
RH
Linklater
Karen M
KM
Mak
Vivian
V
Møller
Henrik
H
Davies
Elizabeth A
EA
D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology* / Q000473:pathology; D004739:England / Q000453:epidemiology; D005260:Female; D054624:Health Status Disparities; D054625:Healthcare Disparities; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology*; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D011336:Probability; D011634:Public Health; D012042:Registries; D018570:Risk Assessment; D012959:Socioeconomic Factors; D016019:Survival Analysis; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology* / Q000473:pathology; D055815:Young Adult