Diego Serraino1, Andrea Gini1, Martina Taborelli1, Guglielmo Ronco2, Paolo Giorgi-Rossi3, Marco Zappa4, Emanuele Crocetti4, Antonella Franzo5, Fabio Falcini6, Carmen Beatriz Visioli4, Fabrizio Stracci7, Manuel Zorzi8, Massimo Federico9, Maria Michiara10, Mario Fusco11, Stefano Ferretti12, Fabio Pannozzo13, Francesco Tisano14, Roberto Zanetti2, Antonella Zucchetto15. 1. Epidemiology and Biostatistics, CRO Aviano National Cancer Institute, Aviano, Italy. 2. Center for Cancer Epidemiology and Prevention, City of Health and Science Hospital, Torino, Italy. 3. Interinstitutional Epidemiology Unit, Local Health Unit, Reggio Emilia, Italy; IRCCS Santa Maria Nuova Hospital, Reggio Emilia, Italy. 4. Cancer Prevention and Research Institute, Firenze, Italy. 5. Friuli Venezia Giulia Central Health Direction, Udine, Italy. 6. Romagna Cancer Registry, IRCCS "Istituto scientifico romagnolo per lo studio e la cura dei tumori" Institute, Meldola, Italy. 7. Department of Medical and Surgical Specialties and Public Health, Perugia University, Perugia, Italy. 8. Veneto Tumour Registry, Veneto Region, Padova, Italy. 9. Department of Oncology, Hematology and Respiratory Diseases, University of Modena and Reggio Emilia, Modena, Italy. 10. University Hospital, Parma, Italy. 11. Napoli 3 South Local Health Unit, Brusciano, Italy. 12. Ferrara University and Ferrara Local Health Unit, Ferrara, Italy. 13. Latina Local Health Unit, Latina, Italy. 14. Siracusa Local Health Unit, Siracusa, Italy. 15. Epidemiology and Biostatistics, CRO Aviano National Cancer Institute, Aviano, Italy. Electronic address: zucchetto.epi@cro.it.
Abstract
OBJECTIVE: To quantify the impact of organized cervical screening programs (OCSPs) on the incidence of invasive cervical cancer (ICC), comparing rates before and after activation of OCSPs. METHODS: This population-based investigation, using individual data from cancer registries and OCSPs, included 3557 women diagnosed with ICC at age 25-74years in 1995-2008. The year of full-activation of each OCSP was defined as the year when at least 40% of target women had been invited. Incidence rate ratios (IRRs) with 95% confidence intervals (95% CIs) were calculated as the ratios between age-standardized incidence rates observed in periods after full-activation of OCSPs vs those observed in the preceding quinquennium. RESULTS: ICC incidence rates diminished with time since OCSPs full-activation: after 6-8years, the IRR was 0.75 (95% CI: 0.67-0.85). The reduction was higher for stages IB-IV (IRR=0.68, 95% CI: 0.58-0.80), squamous cell ICCs (IRR=0.74, 95% CI: 0.64-0.84), and particularly evident among women aged 45-74years. Conversely, incidence rates of micro-invasive (stage IA) ICCs increased, though not significantly, among women aged 25-44years (IRR=1.34, 95% CI: 0.91-1.96). Following full-activation of OCSPs, micro-invasive ICCs were mainly and increasingly diagnosed within OCSPs (up to 72%). CONCLUSION(S): Within few years from activation, organized screening positively impacted the already low ICC incidence in Italy and favored down-staging.
OBJECTIVE: To quantify the impact of organized cervical screening programs (OCSPs) on the incidence of invasive cervical cancer (ICC), comparing rates before and after activation of OCSPs. METHODS: This population-based investigation, using individual data from cancer registries and OCSPs, included 3557 women diagnosed with ICC at age 25-74years in 1995-2008. The year of full-activation of each OCSP was defined as the year when at least 40% of target women had been invited. Incidence rate ratios (IRRs) with 95% confidence intervals (95% CIs) were calculated as the ratios between age-standardized incidence rates observed in periods after full-activation of OCSPs vs those observed in the preceding quinquennium. RESULTS: ICC incidence rates diminished with time since OCSPs full-activation: after 6-8years, the IRR was 0.75 (95% CI: 0.67-0.85). The reduction was higher for stages IB-IV (IRR=0.68, 95% CI: 0.58-0.80), squamous cell ICCs (IRR=0.74, 95% CI: 0.64-0.84), and particularly evident among women aged 45-74years. Conversely, incidence rates of micro-invasive (stage IA) ICCs increased, though not significantly, among women aged 25-44years (IRR=1.34, 95% CI: 0.91-1.96). Following full-activation of OCSPs, micro-invasive ICCs were mainly and increasingly diagnosed within OCSPs (up to 72%). CONCLUSION(S): Within few years from activation, organized screening positively impacted the already low ICC incidence in Italy and favored down-staging.
Authors: Annarosa Del Mistro; Helena Frayle; Martina Rizzi; Gianpiero Fantin; Antonio Ferro; Paolo Matteo Angeletti; Paolo Giorgi Rossi; Emma Altobelli Journal: PLoS One Date: 2017-03-06 Impact factor: 3.240
Authors: Maria G Cappelli; Francesca Fortunato; Silvio Tafuri; Sara Boccalini; Paolo Bonanni; Rosa Prato; Domenico Martinelli Journal: Eur J Cancer Care (Engl) Date: 2018-09-04 Impact factor: 2.520
Authors: Justina Paulauskiene; Mindaugas Stelemekas; Rugile Ivanauskiene; Janina Petkeviciene Journal: Int J Environ Res Public Health Date: 2019-12-11 Impact factor: 3.390
Authors: Annarosa Del Mistro; Jessica Battagello; Luca Weis; Vittoria Bressan; Vittorio Selle; Mauro Ramigni; Alessandra Dal Zotto; Antonio Maggiolo; Silvia Gori; Helena Frayle; Marco Zappa; Manuel Zorzi Journal: Viruses Date: 2021-03-16 Impact factor: 5.048