Cervical cancer incidence in Denmark: Disentangling determinants of time trend
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Cervical cancer incidence in Denmark : Disentangling determinants of time trend. / Lynge, Elsebeth; Bennekou Schroll, Jeppe; Andersen, Berit; Balasubramaniam, Kirubakaran; Poulsgaard Frandsen, Anna; Ibfelt, Else Helene; Jochumsen, Kirsten Marie; Bruun Laustsen, Maja Ulrikka; Nielsen, Susanne; Salmani, Rouzbeh; Schledermann, Doris; Hall Viborg, Petra Birgitta; Waldstrøm, Marianne; Napolitano, George; Serizawa, Reza.
In: International Journal of Cancer, 2024.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Cervical cancer incidence in Denmark
T2 - Disentangling determinants of time trend
AU - Lynge, Elsebeth
AU - Bennekou Schroll, Jeppe
AU - Andersen, Berit
AU - Balasubramaniam, Kirubakaran
AU - Poulsgaard Frandsen, Anna
AU - Ibfelt, Else Helene
AU - Jochumsen, Kirsten Marie
AU - Bruun Laustsen, Maja Ulrikka
AU - Nielsen, Susanne
AU - Salmani, Rouzbeh
AU - Schledermann, Doris
AU - Hall Viborg, Petra Birgitta
AU - Waldstrøm, Marianne
AU - Napolitano, George
AU - Serizawa, Reza
N1 - © 2024 The Author(s). International Journal of Cancer published by John Wiley & Sons Ltd on behalf of UICC.
PY - 2024
Y1 - 2024
N2 - Cervical cancer is a preventable disease. Nevertheless, stagnation has been seen in incidence rates also in countries with well-functioning healthcare. On this basis, we investigated associations between control interventions and changes in cervical cancer incidence in Denmark from 2009 to 2022. Data on human papillomavirus (HPV)-vaccination were retrieved from Staten's Serum Institute; on screening recommendations from Danish Health Authority, on screening performance from Danish Quality Database for Cervical Screening; and on cervical cancer incidence from Nordcan and Danish Cancer Register. We reported coverage with HPV vaccination (1+ dose); coverage with cervical cell samples; number of women with primary HPV tests; proportion of non-normal cell samples without timely follow-up; number of conizations; and cervical cancer incidence rates. In 2022, all women aged ≤29 had been offered childhood HPV vaccination with coverage of 80%-90%. By 2020-2022, the cervical cancer incidence rate in women aged 20-29 was 3 per 100,000; at level of disease elimination. In 2017, women aged 70+ were offered a one-time HPV screening, and by 2020-2022, the old-age peak in cervical cancer incidence had largely disappeared. From 2009 to 2022, proportion of non-normal cell samples without timely follow-up decreased from 20% to 10%, and conventional cytology was largely replaced by SurePath liquid-based cytology; these factors could explain the steady decrease in cervical cancer incidence rate. Implementation of primary HPV screening in women aged 30-59 in 2021 was reflected in a, probably temporary, increase in the 2022 cervical cancer incidence rate. In conclusion, combined interventions with childhood HPV vaccination; one-time HPV screening of elderly women; and better management of screening broke previous stagnation in cervical cancer incidence rate.
AB - Cervical cancer is a preventable disease. Nevertheless, stagnation has been seen in incidence rates also in countries with well-functioning healthcare. On this basis, we investigated associations between control interventions and changes in cervical cancer incidence in Denmark from 2009 to 2022. Data on human papillomavirus (HPV)-vaccination were retrieved from Staten's Serum Institute; on screening recommendations from Danish Health Authority, on screening performance from Danish Quality Database for Cervical Screening; and on cervical cancer incidence from Nordcan and Danish Cancer Register. We reported coverage with HPV vaccination (1+ dose); coverage with cervical cell samples; number of women with primary HPV tests; proportion of non-normal cell samples without timely follow-up; number of conizations; and cervical cancer incidence rates. In 2022, all women aged ≤29 had been offered childhood HPV vaccination with coverage of 80%-90%. By 2020-2022, the cervical cancer incidence rate in women aged 20-29 was 3 per 100,000; at level of disease elimination. In 2017, women aged 70+ were offered a one-time HPV screening, and by 2020-2022, the old-age peak in cervical cancer incidence had largely disappeared. From 2009 to 2022, proportion of non-normal cell samples without timely follow-up decreased from 20% to 10%, and conventional cytology was largely replaced by SurePath liquid-based cytology; these factors could explain the steady decrease in cervical cancer incidence rate. Implementation of primary HPV screening in women aged 30-59 in 2021 was reflected in a, probably temporary, increase in the 2022 cervical cancer incidence rate. In conclusion, combined interventions with childhood HPV vaccination; one-time HPV screening of elderly women; and better management of screening broke previous stagnation in cervical cancer incidence rate.
U2 - 10.1002/ijc.35081
DO - 10.1002/ijc.35081
M3 - Journal article
C2 - 39003657
JO - International Journal of Cancer
JF - International Journal of Cancer
SN - 0020-7136
ER -
ID: 398353355