Trends in High-grade Cervical Lesions and Cervical Cancer Screening in 5 States, 2008-2015.
Clin Infect Dis
; 68(8): 1282-1291, 2019 04 08.
Article
em En
| MEDLINE
| ID: mdl-30137283
ABSTRACT
BACKGROUND:
We describe changes in rates of cervical intraepithelial neoplasia grades 2, 3 and adenocarcinoma in situ (CIN2+) during a period of human papillomavirus (HPV) vaccine uptake and changing cervical cancer screening recommendations.METHODS:
We conducted population-based laboratory surveillance for CIN2+ in catchment areas in 5 states, 2008-2015. We calculated age-specific CIN2+ rates per 100000 women by age groups. We estimated incidence rate ratios (IRR) of CIN2+ for 2-year periods among all women and among screened women to evaluate changes over time.RESULTS:
A total of 16572 CIN2+ cases were reported. Among women aged 18-20 and 21-24 years, CIN2+ rates declined in all sites, whereas in women aged 25-29, 30-34, and 35-39 years, trends differed across sites. The percent of women screened annually declined in all sites and age groups. Compared to 2008-2009, rates among screened women were significantly lower for all 3 periods in women aged 18-20 years (2010-2011 IRR 0.82, 95% confidence interval [CI] 0.67-0.99; 2012-2013 IRR 0.63, 95% CI 0.47-0.85; 2014-2015 IRR 0.44, 95% CI 0.28-0.68) and lower for the latter 2 time periods in women aged 21-24 years (2012-2013 IRR 0.86, 95% CI 0.79-0.94; 2014-2015 IRR 0.61, 95% CI 0.55-0.67).CONCLUSIONS:
From 2008-2015, both CIN2+ rates and cervical cancer screening declined in women aged 18-24 years. The significant decreases in CIN2+ rates among screened women aged 18-24 years are consistent with a population-level impact of HPV vaccination.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Displasia do Colo do Útero
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Neoplasias do Colo do Útero
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Vacinas contra Papillomavirus
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Detecção Precoce de Câncer
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Adenocarcinoma in Situ
Tipo de estudo:
Diagnostic_studies
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Screening_studies
Limite:
Adolescent
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Adult
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Female
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Humans
País como assunto:
America do norte
Idioma:
En
Ano de publicação:
2019
Tipo de documento:
Article