Younger age distribution of cervical cancer incidence among survivors of pediatric and young adult cancers

Abstract

BackgroundPediatric and young adult (PAYA) cancer survivors may have an earlier onset of chronic diseases compared with the general population. We compared the age at cervical cancer diagnosis between PAYA cancer survivors and females in the general US population. MethodsWe used longitudinal data from 9 population-based registries of the Surveillance, Epidemiology, and End Results program collected between 1973 and 2010. PAYA cancer survivors were females diagnosed with any cancer before age 30years, survived at least 5years post-diagnosis, and were subsequently diagnosed with invasive cervical cancer (n=46). The general US population comprised females who were diagnosed with invasive cervical cancer as the primary malignancy (n=26,956). We estimated the difference in median age at diagnosis (ß50) and bootstrap 95% confidence limits (CL) of invasive cervical cancer after adjustment for year of diagnosis and race. ResultsThe median age at diagnosis of invasive cervical cancer was 33years for female PAYA cancer survivors and 40years for females in the general US population (ß50=−7.0, 95% CL: −11, −3.2). Similar differences were observed across subgroups of stage and histologic subtype of invasive cervical cancer. ConclusionOur results suggest that PAYA cancer survivors are diagnosed with invasive cervical cancer at a substantially younger age compared with females without a prior cancer diagnosis in the general US population. This issue warrants further study, and could have implications for determining age at initiation or frequency of cervical cancer screening if younger age at diagnosis is attributable to an underlying biological phenomenon.