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Trends in cervical cancer in the Netherlands until 2007: Has the bottom been reached?
Author(s) -
de Kok Inge M.C.M.,
van der Aa Maaike A.,
van Ballegooijen Marjolein,
Siesling Sabine,
KarimKos Henrike E.,
van Kemenade Folkert J.,
Coebergh Jan Willem W.
Publication year - 2011
Publication title -
international journal of cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.475
H-Index - 234
eISSN - 1097-0215
pISSN - 0020-7136
DOI - 10.1002/ijc.25553
Subject(s) - medicine , incidence (geometry) , confidence interval , cervical cancer , cancer registry , demography , cervical intraepithelial neoplasia , cancer , mortality rate , rate ratio , physics , sociology , optics
We explored trends in incidence and mortality of cervical cancer by age, stage and morphology, and linked the observed trends to screening activities. Data was retrieved from the Netherlands Cancer Registry during 1989–2007 (incidence) and Statistics Netherlands during 1970–2007 (mortality). Trends were evaluated by calculating the estimated annual percentage change (EAPC). Joinpoint regression analysis was used to detect changes in trends. Cervical intraepithelial neoplasia (CIN) detection rates were calculated by data from “the nationwide network and registry of histo‐ and cytopathology” during 1990–2006. Total age‐adjusted incidence rate (European standardized rate (ESR)) was 7.9 per 100,000 woman years in 2007. During 1989–1998, incidence rates decreased with an EAPC of −1.3% (95% confidence interval (CI) −2.2 to −0.3), during 1998–2001 with −6.7% (95% CI: −16.4 to 4.1), and increased during 2001–2007 with 2.3% (95% CI: 0.4 to 4.2). Total mortality ESR was 1.9 per 100,000 woman years in 2007. Mortality rates decreased during 1970–1994 annually with −4.1% (95% CI: −4.6% to −3.7%), and with −2.6% (95% CI: −3.8% to −1.5%) during 1994–2007. The observed trend in total incidence is similar to the trend in squamous cell carcinomas in age group 35–54 years, suggesting that the observed trends are likely to be associated to changes in the screening program. This is supported by the trend in CINIII detection rates. In conclusion, incidence and mortality overall decreased and leveled off. On top of that there was an extra decrease that was compensated by a following recent increase in incidence, probably resulting from reorganization of the Dutch screening program.