Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Sep 1;139(5):1040-5.
doi: 10.1002/ijc.30152. Epub 2016 May 6.

Is cervical screening preventing adenocarcinoma and adenosquamous carcinoma of the cervix?

Alejandra Castanon  1 , Rebecca Landy  1 , Peter D Sasieni  1
Affiliations

Is cervical screening preventing adenocarcinoma and adenosquamous carcinoma of the cervix?

Alejandra Castanon et al. Int J Cancer. .

Abstract

While the incidence of squamous carcinoma of the cervix has declined in countries with organised screening, adenocarcinoma has become more common. Cervical screening by cytology often fails to prevent adenocarcinoma. Using prospectively recorded cervical screening data in England and Wales, we conducted a population-based case-control study to examine whether cervical screening leads to early diagnosis and down-staging of adenocarcinoma. Conditional logistic regression modelling was carried out to provide odds ratios (ORs) and 95% confidence intervals (CIs) on 12,418 women with cervical cancer diagnosed between ages 30 and 69 and 24,453 age-matched controls. Of women with adenocarcinoma of the cervix, 44.3% were up to date with screening and 14.6% were non-attenders. The overall OR comparing women up to date with screening with non-attenders was 0.46 (95% CI: 0.39-0.55) for adenocarcinoma. The odds were significantly decreased (OR: 0.22, 95% CI: 0.15-0.33) in up to date women with Stage 2 or worse adenocarcinoma, but not for women with Stage1A adenocarcinoma 0.71 (95% CI: 0.46-1.09). The odds of Stage 1A adenocarcinoma was double among lapsed attenders (OR: 2.35, 95% CI: 1.52-3.62) compared to non-attenders. Relative to women with no negative cytology within 7 years of diagnosis, women with Stage1A adenocarcinoma were very unlikely to be detected within 3 years of a negative cytology test (OR: 0.08, 95% CI: 0.05-0.13); however, the odds doubled 3-5 years after a negative test (OR: 2.30, 95% CI: 1.67-3.18). ORs associated with up to date screening were smaller for squamous and adenosquamous cervical carcinoma. Although cytology screening is inefficient at preventing adenocarcinomas, invasive adenocarcinomas are detected earlier than they would be in the absence of screening, substantially preventing Stage 2 and worse adenocarcinomas.

Keywords: adenocarcinoma; adenosquamous; cervical cancer; effectiveness of screening; screening.

PubMed Disclaimer

References

    1. Mathew A, George PS. Trends in incidence and mortality rates of squamous cell carcinoma and adenocarcinoma of cervix—worldwide. Asian Pac J Cancer Prev 2009;10:645–50. - PubMed
    1. Lonnberg S, Hansen BT, Haldorsen T, et al. Cervical cancer prevented by screening: long‐term incidence trends by morphology in Norway. Int J Cancer 2015;137:1758–64. - PubMed
    1. Vinh‐Hung V, Bourgain C, Vlastos G, et al. Prognostic value of histopathology and trends in cervical cancer: a SEER population study. BMC Cancer 2007;7:164 - PMC - PubMed
    1. Adegoke O, Kulasingam S, Virnig B. Cervical cancer trends in the United States: a 35‐year population‐based analysis. J Women's Health (Larchmt) 2012;21:1031–7. - PMC - PubMed
    1. Sherman ME, Wang SS, Carreon J, et al. Mortality trends for cervical squamous and adenocarcinoma in the United States. Relation to incidence and survival. Cancer 2005;103:1258–64. - PubMed

Publication types

MeSH terms