Abstract
BackgroundThe incidence of cervical cancer varies dramatically, both globally and within individual countries. The age-standardised incidence of cervical cancer was compared across primary care trusts (PCTs) in South East England, taking into account the prevalence of known behavioural risk factors, screening coverage and the deprivation of the area.MethodsData on 2,231 cases diagnosed between 2001 and 2005 were extracted from the Thames Cancer Registry, and data on risk factors and screening coverage were collated from publicly available sources. Age-standardised incidence rates were calculated for each PCT using cases of squamous cell carcinoma in the screening age group (25–64 years).ResultsThe age-standardised incidence rate for cervical cancer in South East England was 6.7 per 100,000 population (European standard) but varied 3.1 fold between individual PCTs. Correlations between the age-standardised incidence rate and smoking prevalence, teenage conception rates, and deprivation were highly significant at the PCT level (p < 0.001). However, screening coverage was not associated with the incidence of cervical cancer at the PCT level. Poisson regression indicated that these variables were all highly correlated and could not determine the level of independent contribution at a population level.ConclusionThere is excess disease burden within South East England. Significant public health gains can be made by reducing exposure to known risk factors at a population level.
Highlights
The incidence of cervical cancer varies dramatically, both globally and within individual countries
This study aimed to quantify the relationship between cervical cancer incidence and aetiological risk factors and screening coverage at a population level; and to investigate whether deprivation itself predicts an additional risk to the population studied
human papilloma virus (HPV) infection rates are not routinely measured, teenage conception rates can act as a proxy for the early sexual contact which confers a behaviour risk for Tumour description Table 1 illustrates the histological classification of incident cases of cervical cancer in the Thames Cancer Registry (TCR) in the years between 2001 and 2005
Summary
The incidence of cervical cancer varies dramatically, both globally and within individual countries. The age-standardised incidence of cervical cancer was compared across primary care trusts (PCTs) in South East England, taking into account the prevalence of known behavioural risk factors, screening coverage and the deprivation of the area. The 5-year survival rates for this cancer are relatively high, on average women are diagnosed and die at a younger age than in most other types of cancer. Cervical cancer rates eighth in terms of cancer incidence in the United Kingdom [2]. Within the United Kingdom, rates of cervical cancer are highest in the Yorkshire and North West regions of England, and Scotland; and lowest in the Eastern, South East and London regions of England [2]. Within London, a recent report highlighted the link between socio-eco-
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