Screening frequency and histologic type influence the efficacy of cervical cancer screening: A nationwide cohort study

Ying-Cheng Chiang; Yun-Yuan Chen; Shu-Feng Hsieh; Chun-Ju Chiang; San-Lin You; Wen-Fang Cheng; Mei-Shu Lai; Chi-An Chen; Taiwan Cervical Cancer Prevention Surveillance Center

doi:10.1016/j.tjog.2017.01.010

Screening frequency and histologic type influence the efficacy of cervical cancer screening: A nationwide cohort study

Taiwan J Obstet Gynecol. 2017 Aug;56(4):442-448. doi: 10.1016/j.tjog.2017.01.010.

Authors

Ying-Cheng Chiang¹, Yun-Yuan Chen², Shu-Feng Hsieh¹, Chun-Ju Chiang³, San-Lin You⁴, Wen-Fang Cheng⁵, Mei-Shu Lai⁶, Chi-An Chen¹; Taiwan Cervical Cancer Prevention Surveillance Center

Affiliations

¹ Department of Obstetrics and Gynecology, College of Medicine, National Taiwan University, Taipei, Taiwan.
² Department of Obstetrics and Gynecology, College of Medicine, National Taiwan University, Taipei, Taiwan; Department of Research, Taiwan Blood Services Foundation, Taipei, Taiwan.
³ Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan; Taiwan Cancer Registry, Taipei, Taiwan.
⁴ Department of Public Health, College of Medicine, Big Data Research Centre, Fu-Jen Catholic University, New Taipei City, Taiwan. Electronic address: yousanlin@gamil.com.
⁵ Department of Obstetrics and Gynecology, College of Medicine, National Taiwan University, Taipei, Taiwan; Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan; Graduate Institute of Oncology, College of Medicine, National Taiwan University, Taipei, Taiwan. Electronic address: wenfangcheng@yahoo.com.
⁶ Graduate Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.

PMID: 28805598
DOI: 10.1016/j.tjog.2017.01.010

Abstract

Objective: To evaluate the influence of age, screening interval, and histologic type on the effect of Pap smears in cervical cancer screening.

Materials and methods: Data were retrieved from the Taiwan National Cancer Registry and Cervical Cancer Screening Registration System for the period from 2002 to 2010. Age, Pap smear interval, FIGO stage, and histology were further analyzed.

Results: A total of 12,294 women with cervical cancer were enrolled, including 10,040 with squamous cell carcinoma (SCC), 1720 with adenocarcinoma (ADC), 401 with adenosquamous carcinoma (ASC), and 133 with small cell neuroendocrine carcinoma (SMC). Women who had a Pap smear at an interval of <3 years had a significantly higher proportion of stage I disease than women who had never undergone cervical cancer screening (p < 0.0001). Greater than 40% of women with SCCs in each age group had never had a Pap smear; however, women with ADCs were predominantly in the younger age and greater than 40% of women with ADCs had Pap smear at intervals < 3 years.

Conclusions: Pap smear is more effective in screening for cervical SCCs compared to cervical ADCs. Improving adherence to screening recommendations is important for the prevention of cervical SCC, especially in elderly women.

Keywords: Adenocarcinoma; Cervical cancer; Pap smear; Squamous cell carcinoma.

MeSH terms

Adenocarcinoma / diagnosis*
Adenocarcinoma / pathology
Adult
Age Factors
Aged
Carcinoma, Squamous Cell / diagnosis*
Carcinoma, Squamous Cell / pathology
Cervix Uteri / pathology
Cohort Studies
Early Detection of Cancer / methods*
Female
Humans
Mass Screening / methods
Middle Aged
Papanicolaou Test / statistics & numerical data*
Registries
Taiwan
Time Factors
Uterine Cervical Neoplasms / diagnosis*
Uterine Cervical Neoplasms / pathology
Vaginal Smears / statistics & numerical data*