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. 2017 Oct:103:60-65.
doi: 10.1016/j.ypmed.2017.07.027. Epub 2017 Jul 29.

Surveillance of high-grade cervical cancer precursors (CIN III/AIS) in four population-based cancer registries, United States, 2009-2012

Meg Watson  1 , Ashwini Soman  2 , Elaine W Flagg  3 , Elizabeth Unger  4 , Dennis Deapen  5 , Vivien W Chen  6 , Lauren C Peres  6 , Glenn Copeland  7 , Thomas C Tucker  8 , Erin Garnett  9 , Mona Saraiya  10
Affiliations

Surveillance of high-grade cervical cancer precursors (CIN III/AIS) in four population-based cancer registries, United States, 2009-2012

Meg Watson et al. Prev Med. 2017 Oct.

Abstract

Surveillance of cervical intraepithelial neoplasia grade III (CIN III) and adenocarcinoma in situ (AIS) is important for determining the burden of a preventable disease, identifying effects of vaccination on future diagnoses, and developing targeted programs. We analyzed population-based rates of high-grade cervical cancer precursor lesions using data from four central cancer registries (diagnosis years 2009-2012 from Louisiana, Kentucky, Michigan, and diagnosis years 2011-2012 from Los Angeles) by age, race, and histology. We also compared rates of precursors to invasive cancers. With 4 complete years of data from Michigan, we were able to conduct a trend analysis for that state. Data analysis was conducted in Atlanta during 2016. Kentucky reported the highest rate of CIN III/AIS (69.8), followed by Michigan (55.4), Louisiana (42.3), and Los Angeles (19.2). CIN III/AIS rates declined among women in Michigan by 37% each year for women aged 15-19, 14% for those aged 20-24, and 7% for those aged 25-29. Rates of CIN III/AIS vary by registry, and were higher than invasive cancer. In Michigan, declines in CIN III/AIS among women aged 15-29 are likely related in part to updated screening recommendations, and to the impact of human papillomavirus vaccination.

Keywords: Cervical cancer; Cervical intraepithelial neoplasia; HPV; HPV vaccines; Population-based cancer registries.

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Conflict of interest statement

Conflicts of Interests: The authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1
Figure 1. Rate of High-Grade Cervical Cancer Precursors (CIN III/AIS) by Age, Four US Central Cancer Registries, 2009–2012
FOOTNOTES:*Cervical adenocarcinoma in situ is included with CIN III. CIN III/AIS = Cervical intraepithelial neoplasia Grade 3 and adenocarcinoma in situ. ICC = Invasive cervical cancer. Data on CIN III/AIS and ICC from Kentucky, Louisiana, and Michigan 2009–2012; Los Angeles 2011–2012. Data analysis was conducted in Atlanta during 2016.
Figure 2
Figure 2. Short-Term Trends in High-Grade Cervical Cancer Precursors (CIN III/AIS), Michigan Cancer Registry, 2009–2012
APC = Annual percent change. *Indicates APC was statistically significant (p<0.05). Data analysis was conducted in Atlanta during 2016.
See this image and copyright information in PMC

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