K Marquardt1, M Stubbe2, U Broschewitz2. 1. Praxis für Pathologie, Güstrower Str. 34, 19055, Schwerin, Deutschland. gynpatho-schwerin@arcor.de. 2. Praxis für Pathologie, Rostock, Deutschland.
Abstract
BACKGROUND: In view of the discussion on primary human papillomavirus (HPV) screening it was necessary to evaluate recent and reliable data from the current cytology-based screening program. METHODS: Since the year 2004 all cases of cervical cancer must be reported to the Joint State Quality Control Commission in Mecklenburg-Western Pomerania, corrected and supplemented by data of the State Cancer Registry. The screening histories of all patients, age, tumor stages and histological tumor types were analyzed. RESULTS: Over a 10-year period (2004-2013) 985 women with invasive cervical cancer and complete data were identified, of whom 573 patients (58 %) had not had a cervical smear within the past 5 years, an irregular screening history was found in 312 patients (32 %) and 100 patients (10 %) had cervical cancer despite regular participation. In women who did not participate in the screening program, tumor stages T1b and higher were found in 85 %. In the group of women with regular screening 53 % were diagnosed with microinvasive cancer and in 38 % of women with irregular screening. The age distribution showed a peak for cervical cancer in the age group of 40-54 years. Squamous cell carcinoma dominated and adenocarcinoma was found in 17 % which showed a tendency to increase over the investigation time period. CONCLUSION: Most cervical cancers and the advanced stages were found in women who did not participate in the screening program.
BACKGROUND: In view of the discussion on primary human papillomavirus (HPV) screening it was necessary to evaluate recent and reliable data from the current cytology-based screening program. METHODS: Since the year 2004 all cases of cervical cancer must be reported to the Joint State Quality Control Commission in Mecklenburg-Western Pomerania, corrected and supplemented by data of the State Cancer Registry. The screening histories of all patients, age, tumor stages and histological tumor types were analyzed. RESULTS: Over a 10-year period (2004-2013) 985 women with invasive cervical cancer and complete data were identified, of whom 573 patients (58 %) had not had a cervical smear within the past 5 years, an irregular screening history was found in 312 patients (32 %) and 100 patients (10 %) had cervical cancer despite regular participation. In women who did not participate in the screening program, tumor stages T1b and higher were found in 85 %. In the group of women with regular screening 53 % were diagnosed with microinvasive cancer and in 38 % of women with irregular screening. The age distribution showed a peak for cervical cancer in the age group of 40-54 years. Squamous cell carcinoma dominated and adenocarcinoma was found in 17 % which showed a tendency to increase over the investigation time period. CONCLUSION: Most cervical cancers and the advanced stages were found in women who did not participate in the screening program.
Entities:
Keywords:
Adenocarcinoma of the uterine cervix; Cancer screening; Cervical cancer; Cervical cytology; Screening failure
Authors: Elisabeth Gummersbach; Jürgen in der Schmitten; Achim Mortsiefer; Heinz-Harald Abholz; Karl Wegscheider; Michael Pentzek Journal: Dtsch Arztebl Int Date: 2015-01-30 Impact factor: 5.594