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Risk for advanced cervical cancer lower among those who are screened
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Women screened for cervical cancer have a lesser chance of being diagnosed with the disease than those who are not, according to recent data published in the Journal of the National Cancer Institute.
Researchers from various sites in Sweden conducted a nationwide audit and identified 1,230 cases of cervical cancer reported to the Swedish Cancer Registry. Squamous cell carcinoma was the most prevalent type among all age groups. Among those between the ages of 30 and 65 years at diagnosis, adenocarcinomas were more common.
The risk for cervical cancer was higher in women who had not had a Pap smear than those who were screened (OR=2.52; 95% CI, 2.19 to 2.91). The researchers also found an increased risk for nonsquamous cell cervical cancers for these women (OR=1.59; 95% CI, 1.20 to 2.11). The risk for advanced cancers was also high among women who had not been screened within the recommended time (OR=4.82; 95% CI, 3.61 to 6.44).
The risk for cervical cancer was higher among women with abnormal Pap smears than those with normal smears who had been screened during the suggested period (OR=7.55; 95% CI, 5.88 to 9.69). – by Stacey L. Adams
J Natl Cancer Inst. 2008;100:1-8.
This study has the advantage of population-based data of the entire country. The researchers looked at the impact of screening very specifically in a group of people — individuals who did participate and those who did not — and they showed nicely and importantly the major risk factor. They looked at all invasive cancers in Sweden over a decade — 1,200 cases — and they were then able to go back. They showed that those individuals who participated in the screening had a much lower risk; the women who did not have a Pap smear had a particularly higher risk of advanced cancers. This shows that screening has had a major impact; the implication here is particularly important. This information does not say that screening is going to prevent cervical cancer, but it says that if a woman is going to have cervical cancer, getting screened gives her a much higher probability of either having a low-grade cancer, which has a much better opportunity to be cured and treated with less morbidity, or to have something like severe dysplasia that is treated. This is very powerful information. In some ways, you can say, don’t we already know this? The answer is, yes, but when you actually look at the data and the level of benefit — which is not theoretical, it is real — it is very strong support for the importance of these screening strategies. These are particularly recommended screening strategies, not just some theoretical strategies; the actual recommended strategies were used, which have been accepted for a long time and it has a major impact.
– Maurie Markman, MD
HemOnc Today Editorial Board member