ABSTRACT
Fundamento y objetivo: La vigilancia epidemiológica del cáncer de cérvix (CC) debería extenderse desde el cribado hasta la mortalidad. El objetivo de este trabajo es proporcionar una visión global del CC en la provincia de Girona entre 1990-2004. Se trata de un estudio longitudinal que incluye la incidencia de carcinoma in situ (CISC) e invasor (CIC), mortalidad, supervivencia e historial de cribado (HdC) en 1/3 de las afectadas.Pacientes y método: Se han calculado las tasas anuales y quinquenales de incidencia cruda y ajustada por edad de CISC, de CIC y de mortalidad, así como la supervivencia relativa a los 5 años. Se han utilizado modelos de regresión Joinpointpara estimar el porcentaje de cambio anual (PCA) y cambios de tendencia. Se han revisado las citologías de cribado. Resultados: Se diagnosticaron 373 casos incidentes de CIC y 1.093 de CISC. Tras un ascenso inicial en la incidencia de ambos tipos, la tasa ajustada de CISC se estabilizó alrededor de los 28 casos por 100.000 y la de CIC descendió hasta 5,8 casos por 100.000 en el período 2000-2004. La mortalidad se ha mantenido estable y la supervivencia ha aumentado, aunque de forma no significativa. En los casos con HdC un 50% de las mujeres con CIC no tenía citología previa, en contraste con el alto porcentaje de mujeres con CISC que disponían de ésta (92% en 2000-2004). Conclusiones: La incidencia de cáncer de cérvix está descendiendo en Girona, aunque los datos sobre HdC sugieren que ésta podría reducirse aún más (AU)
Background and objective: The epidemiological vigilance of cervical cancer (CC) should comprise from screening to mortality. The objective of the work is to show a global vision of CC in the Province of Girona (Spain) between the years 1990-2004. It is a longitudinal study that includes incidence for in situ (ISCC) and invasive (ICC) carcinoma of the cervix, mortality, relative survival rates and the screening history of 1/3 of the affected women.Patients and method: The crude and the age-adjusted annual and five years incidence rates for ISCC and ICC and the mortality for ICC were calculated. Regression Joinpointmodels were used to estimate the annual percentage change (APC) and the changes in the trend. The five-year relative survival rate was estimated. Cytology screening smears were reviewed. Results: Three hundred seventy-three incident cases of ICC and 1,093 cases of ISCC were diagnosed. After an initial rise of the incidence in both types, the adjusted rate of ISCC stabilized around 28 cases per 100,000 and that of ICC declined to 5.8 cases per 100,000 women in the period 2000-2004. The mortality remained steady and the survival rate had a non-significant increase. In the cases with screening history almost 50% of the women diagnosed of ICC had no previous cytology in contrast with the high percentage of the women with ISCC that had it done (92% in 200-2004). Conclusions: Cervical cancer incidence is decreasing in Girona, although the dates of the screening histories suggest that it can be further reduced (AU)
Subject(s)
Humans , Female , Uterine Cervical Neoplasms/epidemiology , Carcinoma in Situ/epidemiology , Neoplasm Invasiveness , Mass Screening , Epidemiological Monitoring , Cohort Studies , Disease-Free SurvivalABSTRACT
BACKGROUND AND OBJECTIVE: The epidemiological vigilance of cervical cancer (CC) should comprise from screening to mortality. The objective of the work is to show a global vision of CC in the Province of Girona (Spain) between the years 1990-2004. It is a longitudinal study that includes incidence for in situ (ISCC) and invasive (ICC) carcinoma of the cervix, mortality, relative survival rates and the screening history of 1/3 of the affected women. PATIENTS AND METHOD: The crude and the age-adjusted annual and five years incidence rates for ISCC and ICC and the mortality for ICC were calculated. Regression Joinpointmodels were used to estimate the annual percentage change (APC) and the changes in the trend. The five-year relative survival rate was estimated. Cytology screening smears were reviewed. RESULTS: Three hundred seventy-three incident cases of ICC and 1,093 cases of ISCC were diagnosed. After an initial rise of the incidence in both types, the adjusted rate of ISCC stabilized around 28 cases per 100,000 and that of ICC declined to 5.8 cases per 100,000 women in the period 2000-2004. The mortality remained steady and the survival rate had a non-significant increase. In the cases with screening history almost 50% of the women diagnosed of ICC had no previous cytology in contrast with the high percentage of the women with ISCC that had it done (92% in 200-2004). CONCLUSIONS: Cervical cancer incidence is decreasing in Girona, although the dates of the screening histories suggest that it can be further reduced.
