OBJECTIVES: To evaluate screening patterns within organized cervical screening programs (OCSPs) and survival of women with invasive cervical cancer (ICC). METHODS: A population-based study was conducted in Italian areas covered by cancer registries and OCSPs. The study included all women aged 25-65 years diagnosed with ICC between 1995 and 2008, and their screening histories within OCSPs were retrieved. Hazard ratios (HR) of death and 95% confidence intervals (CI) were computed according to screening pattern, using Cox models adjusted for age, ICC stage, and major confounders. RESULTS: Among 3268 women with ICC, 20% were never-invited to OCSP, 36% were never-compliant with OCSP's invitation, 33% were compliant and had a screen-detected ICC within OCSP (i.e., after a positive cytology), and 11% were compliant but had a non-screen-detected ICC. Screen-detected ICCs were more frequently micro-invasive (42%) compared to non-screen-detected ones (14%). Compared to women with screen-detected ICC, the adjusted HRs of death were 1.9 (95% CI 1.5-2.4) for those never-invited, 2.0 (95% CI 1.6-2.5) for never-compliant, and 1.7 (95% CI 1.3-2.4) for compliant women having non-screen-detected ICC. CONCLUSION: Prolonged survival, beyond down-staging, of women with ICC detected within OCSPs in Italy, further calls for improvements of OCSPs' invitational coverage and participation.
OBJECTIVES: To evaluate screening patterns within organized cervical screening programs (OCSPs) and survival of women with invasive cervical cancer (ICC). METHODS: A population-based study was conducted in Italian areas covered by cancer registries and OCSPs. The study included all women aged 25-65 years diagnosed with ICC between 1995 and 2008, and their screening histories within OCSPs were retrieved. Hazard ratios (HR) of death and 95% confidence intervals (CI) were computed according to screening pattern, using Cox models adjusted for age, ICC stage, and major confounders. RESULTS: Among 3268 women with ICC, 20% were never-invited to OCSP, 36% were never-compliant with OCSP's invitation, 33% were compliant and had a screen-detected ICC within OCSP (i.e., after a positive cytology), and 11% were compliant but had a non-screen-detected ICC. Screen-detected ICCs were more frequently micro-invasive (42%) compared to non-screen-detected ones (14%). Compared to women with screen-detected ICC, the adjusted HRs of death were 1.9 (95% CI 1.5-2.4) for those never-invited, 2.0 (95% CI 1.6-2.5) for never-compliant, and 1.7 (95% CI 1.3-2.4) for compliant women having non-screen-detected ICC. CONCLUSION: Prolonged survival, beyond down-staging, of women with ICC detected within OCSPs in Italy, further calls for improvements of OCSPs' invitational coverage and participation.
Keywords:
CI; CR; Cancer Registry; Cervical cancer; Cytology; FIGO; HR; ICC; ICD; International Classification of Diseases; International Federation of Gynecology and Obstetrics; NOS; OCSP; OR; Organized screening program; Screening history; WHO; World Health Organization; confidence interval; hazard ratio; invasive cervical cancer; not otherwise specified; odds ratio; organized cervical screening program
Authors: P Giorgi Rossi; C Fortunato; P Barbarino; S Boveri; S Caroli; A Del Mistro; A Ferro; C Giammaria; M Manfredi; T Moretto; A Pasquini; M Sideri; M C Tufi; C Cogo; E Altobelli Journal: Br J Cancer Date: 2015-01-29 Impact factor: 7.640
Authors: Annarosa Del Mistro; Helena Frayle; Antonio Ferro; Gianpiero Fantin; Emma Altobelli; Paolo Giorgi Rossi Journal: Prev Med Rep Date: 2016-12-23
Authors: Michaela T Hall; Kate T Simms; Jie-Bin Lew; Megan A Smith; Marion Saville; Karen Canfell Journal: PLoS One Date: 2018-02-14 Impact factor: 3.240
Authors: Annarosa Del Mistro; Rachael Adcock; Francesca Carozzi; Anna Gillio-Tos; Laura De Marco; Salvatore Girlando; Raffaella Rizzolo; Helena Frayle; Morena Trevisan; Cristina Sani; Elena Burroni; Paolo Giorgi Rossi; Jack Cuzick; Guglielmo Ronco Journal: Int J Cancer Date: 2018-03-09 Impact factor: 7.396