[In situ and invasive cervical cancer epidemiology in the province of Girona, Spain 1990-2004: incidence, mortality, survival and screening history]

Abstract

Background and objective: The epidemiological vigilance of cervical cancer (CC) should comprise from screening to mortality. The objective of the work is to show a global vision of CC in the Province of Girona (Spain) between the years 1990-2004. It is a longitudinal study that includes incidence for in situ (ISCC) and invasive (ICC) carcinoma of the cervix, mortality, relative survival rates and the screening history of 1/3 of the affected women.

Patients and method: The crude and the age-adjusted annual and five years incidence rates for ISCC and ICC and the mortality for ICC were calculated. Regression Joinpointmodels were used to estimate the annual percentage change (APC) and the changes in the trend. The five-year relative survival rate was estimated. Cytology screening smears were reviewed.

Results: Three hundred seventy-three incident cases of ICC and 1,093 cases of ISCC were diagnosed. After an initial rise of the incidence in both types, the adjusted rate of ISCC stabilized around 28 cases per 100,000 and that of ICC declined to 5.8 cases per 100,000 women in the period 2000-2004. The mortality remained steady and the survival rate had a non-significant increase. In the cases with screening history almost 50% of the women diagnosed of ICC had no previous cytology in contrast with the high percentage of the women with ISCC that had it done (92% in 200-2004).

Conclusions: Cervical cancer incidence is decreasing in Girona, although the dates of the screening histories suggest that it can be further reduced.