TY - JOUR

T1 - Frequency of cervical intraepithelial neoplasia treatment in a well-screened population

AU - Barken, Sidsel Svennekjaer

AU - Rebolj, Matejka

AU - Andersen, Erik Søgaard

AU - Lynge, Elsebeth

N1 - Copyright © 2011 UICC.

PY - 2012

Y1 - 2012

N2 - Treatment of cervical intraepithelial neoplasia (CIN) detectable at screening has helped reduce the incidence of cervical cancer, but has also led to overtreatment. The estimates of overtreatment have often focused on a particular grade of CIN or age group. The aim of this paper was to provide a nationwide population-based estimate of the frequency of CIN treatment per prevented cervical cancer case in a well-screened population. We retrieved the data from the Danish National Population, Patient, Health Insurance, Pathology, and Cancer Registers, and calculated annual age-standardized CIN treatment rates. We estimated the frequency of CIN treatment per prevented cervical cancer case by comparing the cumulative life-time risk of CIN treatment from 1996 onward, with the difference in the cumulative life-time risks of cervical cancer in the prescreening and the screening periods. Since 1996, more than 5,000 CIN treatments were undertaken annually in the population of about 2.2 million women aged 15-84 years, and at present 5.2 CIN treatments are undertaken per 1,000 women aged 20-49. About six women have undergone CIN treatment for each prevented cervical cancer. The frequency of CIN treatment increased after 2004 and at present almost eight women are treated per prevented cervical cancer case. Screening, though effective in reducing the incidence of cervical cancer, leads also to a considerable burden of CIN treatment. Future trends in CIN treatment should be closely monitored.

AB - Treatment of cervical intraepithelial neoplasia (CIN) detectable at screening has helped reduce the incidence of cervical cancer, but has also led to overtreatment. The estimates of overtreatment have often focused on a particular grade of CIN or age group. The aim of this paper was to provide a nationwide population-based estimate of the frequency of CIN treatment per prevented cervical cancer case in a well-screened population. We retrieved the data from the Danish National Population, Patient, Health Insurance, Pathology, and Cancer Registers, and calculated annual age-standardized CIN treatment rates. We estimated the frequency of CIN treatment per prevented cervical cancer case by comparing the cumulative life-time risk of CIN treatment from 1996 onward, with the difference in the cumulative life-time risks of cervical cancer in the prescreening and the screening periods. Since 1996, more than 5,000 CIN treatments were undertaken annually in the population of about 2.2 million women aged 15-84 years, and at present 5.2 CIN treatments are undertaken per 1,000 women aged 20-49. About six women have undergone CIN treatment for each prevented cervical cancer. The frequency of CIN treatment increased after 2004 and at present almost eight women are treated per prevented cervical cancer case. Screening, though effective in reducing the incidence of cervical cancer, leads also to a considerable burden of CIN treatment. Future trends in CIN treatment should be closely monitored.

KW - Adolescent

KW - Adult

KW - Aged

KW - Aged, 80 and over

KW - Early Detection of Cancer

KW - Female

KW - Health Services Misuse

KW - Humans

KW - Incidence

KW - Mass Screening

KW - Middle Aged

KW - Risk Factors

KW - Uterine Cervical Neoplasms

U2 - 10.1002/ijc.26248

DO - 10.1002/ijc.26248

M3 - Journal article

C2 - 21702034

VL - 130

SP - 2438

EP - 2444

JO - International Journal of Cancer

JF - International Journal of Cancer

SN - 0020-7136

IS - 10

ER -