European trends in cervical cancer mortality in relation to national screening programs, 1985-2014.

Autor: Salciccioli I; Harvard School of Public Health, Boston, USA. Electronic address: ing.salci@gmail.com., Zhou CD; Harvard School of Public Health, Boston, USA., Okonji EC; Harvard School of Public Health, Boston, USA., Shalhoub J; Department of Surgery & Cancer, Imperial College London, UK., Salciccioli JD; Department of Medicine, Mount Auburn Hospital, Harvard Medical School, Cambridge, USA., Marshall D; Oxford University Clinical Academic Graduate School, John Radcliffe Hospital, Oxford, UK.
Jazyk: angličtina
Zdroj: Cancer epidemiology [Cancer Epidemiol] 2021 Oct; Vol. 74, pp. 102002. Date of Electronic Publication: 2021 Aug 06.
DOI: 10.1016/j.canep.2021.102002
Abstrakt: Background: Cervical cancer is the fourth leading oncological cause of death in women. Variable trends in cervical cancer mortality have been observed across Europe, despite the widespread adoption of screening programs. This variability has previously been attributed to heterogeneity in the quality of screening programs.
Methods: Age-standardized cervical cancer death rates for European countries between 1985 and 2014 were analyzed using Joinpoint regression. Countries were dichotomized based on year of implementation and population invitational coverage of national population-based cervical cancer screening programs. National cervical cancer mortality trends during the study period were compared based on this classification.
Results: Decreasing trends in mortality were observed in all European countries with the specific exceptions of Bulgaria, Greece and Latvia. The highest rates of cervical cancer mortality throughout the study period were in Romania (16.0-14.9/100,000) and the lowest rates in Italy (1.4-1.2/100,000). The greatest percentage decline in mortality was observed in the United Kingdom and the greatest absolute reduction in mortality was seen in Hungary. European countries which implemented a national population-based cervical cancer screening program prior to 2009 demonstrated greater improvements in cervical cancer mortality outcomes compared to those that did not (p = 0.016).
Conclusion: Cervical cancer mortality is improving in most European countries; however, substantial variation remains. Trends in mortality were associated with the time of implementation of national population-based cervical screening programs.
(Copyright © 2021 Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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