Trends in incidence of, and mortality from, cervical lesions in Ireland: baseline data for future evaluation of the national cervical screening programme.

AIM: To investigate incidence and mortality trends for cervical lesions in Ireland in the period 1994-2008.
METHODS: We used data from the National Cancer Registry, Ireland and national death registration data to calculate age-standardised rates for the periods of interest. We used standardised rate ratios to test whether incidence was associated with socio-demographic variables and used Joinpoint to examine trends by morphology grouping.
RESULTS: Incidence of cervical cancer and cervical intraepithelial neoplasia (CIN3) rose over the period 1994-2008. The annual percentage change for cervical cancer was 1.8% and that for CIN3 was 3.8%. Women resident in the most deprived areas had invasive cervical cancer incidence almost twice as high as those resident in the least deprived areas (standardised rate ratio (SRR)=1.8). Comparing incidence in Ireland to England and Wales, Northern Ireland and Scotland in the three years 2005-2007, the SRRs (other areas vs. Ireland) were 0.70, 0.88 and 0.84 respectively. Cervical cancer rates have fallen in these countries in the same period that there is a rise demonstrated in Ireland.
CONCLUSION: Incidence rates of cervical cancer rose in Ireland steadily, albeit modestly, during 1994-2008, most likely due to long-term changes in patterns of sexual behaviour and contraceptive use. A more pronounced rise in CIN3 rates point to considerable levels of opportunistic screening during this period. Mortality rates have changed little over the past four decades, in contrast to trends in countries with well-organised screening programmes.