The influence of total hysterectomy in a cervical cancer screening population: a register-based cross-sectional study

Prevalence of HPV and pathological changes among women 70 years of age, 10 years after exclusion from the Swedish cervical cancer screening program

PURPOSE

Örebro County introduced an updated screening program 2016 with primary HPV test for women over 30 years and prolonged screening, increasing the cut-off age from 56-60 to 64-70. The aim of this study was to investigate the prevalence of HPV genotypes and their correlation to histological changes in women, 10 years after exclusion from the screening program, due to an eventual implementation of a catch-up program including all women aged 60-70.

METHODS

All women in Örebro County, born 1,946 (n = 1,968), were invited to a liquid-based cell sample with primary HPV screening. Samples were analyzed for hrHPV mRNA and positive samples were genotyped. hrHPV positive women were offered to do a conization.

RESULTS

Out of 809 participants, 31 (3.8%) were hrHPV positive, of these 22 did a conization. Histologically, 5/22 (23%) had LSIL and 5/22 (23%) had HSIL. Normal histology was found in 12/22 (55%). The most prevalent genotypes were HPV 16, 33, 52, 56, and 68. Of the women with HSIL, one case of cervical cancer was confirmed in a recone biopsy after 4 months.

CONCLUSION

The study showed considerable prevalence of hrHPV and histologically confirmed LSIL/HSIL. These data led to catch-up screening for women between 60 and 70 years when overlapping two screening strategies.

Incidence, mortality and determinants of survival from cervical cancer in Northwest Russia: a registry-based cohort study

Background

Cervical cancer is the third most common cancer among women. The evidence from Russia, however, is scarce. We studied the incidence of and mortality from cervical cancer in northwest Russia, and assessed determinants of survival among cervical cancer patients.

Methods

This registry-based historical cohort study obtained data on all primary cases of cervical cancer in the Arkhangelsk region in 2000-2014 from the Arkhangelsk Regional Cancer Registry. One- and 5-y survival was calculated using life tables. Factors associated with survival were studied using Kaplan-Meier curves and Cox regression.

Results

The incidence increased from 10.9 per 100 000 in 2000 to 20.9 per 100 000 in 2014, while mortality increased from 2.0 to 7.8 per 100 000 during the same period. One- and 5-y survival was 77.4% (95% CI 75.4 to 79.4) and 60.0% (95% CI 54.6 to 61.5), respectively. Significant inverse association was observed between survival and stage of cancer. Patients with adenocarcinoma (HR=1.6, 95% CI 1.2 to 2.2), other histological types of cancer (HR=1.8, 95% CI 1.4 to 2.4) and those with undefined histologic type (HR=3.8, 95% CI 2.5 to 5.8) had shorter survival than patients with squamous cell carcinoma.

Conclusions

Incidence of and mortality from cervical cancer in northwest Russia is considerably higher than in developed countries. Increased incidence in recent years may be attributed to increased screening.