The significantly lower risk of cervical cancer at and after the recommended age to begin and end screening compared to breast and colorectal cancer.
OBJECTIVE
We compare risk of cervical, colorectal, and breast cancer (and two pre-cancers: cervical intraepithelial neoplasia (CIN) grade 2-3 and colorectal adenomas) at and after the recommended ages to begin and end screening in the United States.


METHODS
Surveillance, Epidemiology, and End Results data were used with Monte Carlo simulations to estimate risk at and after the ages to screen.


RESULTS
At the age to begin screening, absolute risk of breast and colorectal cancer was 381 and 53 times higher, respectively, than cervical cancer (0.0122, 95% CI: 0.0089-0.0162 and 0.0017, 95% CI: 0.0012-0.0023 vs. 3.2e(-5), 95% CI: 2.3e(-5)-4.3e(-5)). Risk of colorectal adenomas and breast cancer was 45 and 2.4 times higher than CIN 2-3 (0.2319, 95% CI: 0.1287-0.3624 and 0.0122, 95% CI: 0.0089-0.0017 vs. 0.0051, 95% CI: 0.0029-0.0081). After the age to end screening, breast and colorectal cancer risk was 17 and 11 times higher, respectively, than cervical cancer.


CONCLUSIONS
Risk of cervical cancer at and after the recommended ages for screening is significantly lower than that of breast and colorectal cancer. Differences may become more pronounced in the era of HPV vaccines. Comparison of risk between cancers provides a novel perspective to inform future guideline development.
University of Minnesota, Division of Epidemiology & Community Health, USA. Electronic address: whit0787@umn.edu.
Hilary K
HK
Whitham
University of Minnesota, Division of Epidemiology & Community Health, USA.
Shalini L
SL
Kulasingam
D000328:Adult; D000367:Age Factors; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000517:prevention & control; D015179:Colorectal Neoplasms / Q000175:diagnosis* / Q000517:prevention & control; D055088:Early Detection of Cancer / Q000592:standards; D005260:Female; D006801:Humans; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D030361:Papillomavirus Infections / Q000175:diagnosis; D053918:Papillomavirus Vaccines / Q000008:administration & dosage; D012307:Risk Factors; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000517:prevention & control; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis
D053918:Papillomavirus Vaccines
Cervical cancer risk; Comparative risk; Screening guidelines