Document Detail


Screening and adenocarcinoma of the cervix.
MedLine Citation:
PMID:  19449379     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Screening has had a major impact on cervical cancer in many countries. Although there can be no doubt about its effectiveness in preventing squamous-cell carcinoma, there is little evidence of any benefit on adenocarcinoma and adenosquamous carcinoma of the cervix, and many authors have concluded that it is ineffective. A population-based case-control design was used in women aged 20-69 in the United Kingdom, with information on screening obtained from routine databases. Among 3,305 cases with known histology, 641 had adenocarcinoma and 133 adenosquamous carcinoma. The risk reduction associated with 3-yearly screening was greater for squamous carcinoma (75%, 95%CI 71-79%) and adenosquamous carcinoma (83%, 95%CI 68-91%) than for adenocarcinoma (43%, 95%CI 24-58%). Among stage 1B+ cases, 83% (335/406) of women with adenocarcinoma had been screened within 10 years of diagnosis. This is very similar to controls (82%, 3,292/3,965), but much higher than in women with squamous carcinoma (57%, 852/1,493). Incidence of adenocarcinoma was low within 2.5 years of a negative smear (OR 2.3, 95%CI 0.15-0.34), but was no different from the background rates 4.5-5.5 years after a negative smear. We conclude that screening has reduced the incidence of adenocarcinoma of the cervix, but the prognostic value of cytology is less (in both magnitude and duration) for adenocarcinoma than for squamous carcinoma. The impact of screening on adenosquamous carcinoma is similar to its impact on squamous carcinoma.
Authors:
Peter Sasieni; Alejandra Castanon; Jack Cuzick
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  International journal of cancer. Journal international du cancer     Volume:  125     ISSN:  1097-0215     ISO Abbreviation:  Int. J. Cancer     Publication Date:  2009 Aug 
Date Detail:
Created Date:  2009-07-06     Completed Date:  2009-07-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0042124     Medline TA:  Int J Cancer     Country:  United States    
Other Details:
Languages:  eng     Pagination:  525-9     Citation Subset:  IM    
Affiliation:
Cancer Research UK Centre for Epidemiology, Mathematics and Statistics, Wolfson Institute of Preventive Medicine, Bart's & The London School of Medicine, Queen Mary University of London, Charterhouse Square, London, United Kingdom.
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MeSH Terms
Descriptor/Qualifier:
Adenocarcinoma / diagnosis,  epidemiology*,  pathology,  prevention & control*
Adult
Aged
Carcinoma, Adenosquamous / diagnosis,  epidemiology*,  pathology,  prevention & control*
Carcinoma, Squamous Cell / epidemiology,  prevention & control
Case-Control Studies
Colposcopy
Female
Great Britain / epidemiology
Humans
Incidence
Logistic Models
Mass Screening* / methods
Middle Aged
Neoplasm Invasiveness
Uterine Cervical Neoplasms / diagnosis,  epidemiology*,  pathology,  prevention & control*
Grant Support
ID/Acronym/Agency:
C569/A5030//Cancer Research UK; C8162/A6127//Cancer Research UK

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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