Age-related incidence of cervical cancer supports two aetiological components: a population-based register study

作者：Seppa K^*; Pitkaniemi J; Malila N; Hakama M

来源：BJOG: An International Journal of Obstetrics and Gynaecology , 2016, 123(5): 772-778.

DOI：10.1111/1471-0528.13754

• Age-related components
• cervical cancer
• incidence
• time series 1953-2012

ObjectiveTo assess whether age-related incidence of cervical cancer supports two aetiological components and to assess trends in these components due to risk factors and to organised screening in Finland.
DesignPopulation-based register study.
SettingFinnish Cancer Registry.
PopulationCervical cancer cases and female population in Finland in 1953-2012.
MethodsCervical cancer incidence was estimated using Poisson regression where age-specific incidence consists of two (early-age and late-age) normally distributed components.
Main outcome measuresAccumulated net risks (incidences) and numbers of cancer cases attributed to each age-related component by calendar time.
ResultsThe accumulated cervical cancer incidence in 2008-2012 was only 30% of that in 1953-1962, before the screening started. The fit of the observed age-specific rates and the rates based on the two-component model was good. In 1953-62, the accumulated net risk ratio (RR; early-age versus late-age) was 0.42 (95% CI 0.29-0.61). The early-age component disappeared in 1973-77 (RR 0.00; 95% CI 0.00-0.08). Thereafter, the risk for the early-age component increased, whereas the risk for the late-age component decreased, and in 2008-2012 the RR was 0.55 (95% CI 0.24-0.89).
ConclusionsIn Finland, cervical cancer incidence has two age-related components which are likely to indicate differences in risk factors of each component. The trend in risk of both components followed the effects of organised screening. Furthermore, the risk related to the early-age component followed changes in risk factors, such as oncogenic HPV infections and other sexually transmitted diseases and smoking habits.

• 出版日期2016-4