Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland.
Department of Public Health, University of Helsinki, Helsinki, Finland.
BJOG. 2016 Apr;123(5):772-8. doi: 10.1111/1471-0528.13754. Epub 2015 Nov 24.
To assess whether age-related incidence of cervical cancer supports two aetiological components and to assess trends in these components due to risk factors and to organised screening in Finland.
Population-based register study.
Finnish Cancer Registry.
Cervical cancer cases and female population in Finland in 1953-2012.
Cervical cancer incidence was estimated using Poisson regression where age-specific incidence consists of two (early-age and late-age) normally distributed components.
Accumulated net risks (incidences) and numbers of cancer cases attributed to each age-related component by calendar time.
The accumulated cervical cancer incidence in 2008-2012 was only 30% of that in 1953-1962, before the screening started. The fit of the observed age-specific rates and the rates based on the two-component model was good. In 1953-62, the accumulated net risk ratio (RR; early-age versus late-age) was 0.42 (95% CI 0.29-0.61). The early-age component disappeared in 1973-77 (RR 0.00; 95% CI 0.00-0.08). Thereafter, the risk for the early-age component increased, whereas the risk for the late-age component decreased, and in 2008-2012 the RR was 0.55 (95% CI 0.24-0.89).
In Finland, cervical cancer incidence has two age-related components which are likely to indicate differences in risk factors of each component. The trend in risk of both components followed the effects of organised screening. Furthermore, the risk related to the early-age component followed changes in risk factors, such as oncogenic HPV infections and other sexually transmitted diseases and smoking habits.
Cervical cancer incidence has two age-related components which are likely to have differencies in their aetiology.
评估宫颈癌的年龄相关性发病是否支持两个病因学组成部分，并评估由于危险因素和芬兰有组织筛查而导致这些组成部分的趋势。
基于人群的登记研究。
芬兰癌症登记处。
1953-2012 年芬兰的宫颈癌病例和女性人群。
使用泊松回归估计宫颈癌发病率，其中年龄特异性发病率由两个（早龄和老龄）正态分布组成部分组成。
按日历时间累积的净风险（发病率）和归因于每个与年龄相关的组成部分的癌症病例数。
在筛查开始之前，2008-2012 年累积宫颈癌发病率仅为 1953-1962 年的 30%。观察到的年龄特异性率与基于两成分模型的率拟合良好。1953-62 年，累积净风险比（早期年龄与老龄）为 0.42（95%CI 0.29-0.61）。1973-77 年早期年龄成分消失（RR 0.00；95%CI 0.00-0.08）。此后，早期年龄成分的风险增加，而老龄成分的风险降低，2008-2012 年 RR 为 0.55（95%CI 0.24-0.89）。
在芬兰，宫颈癌的发病率有两个与年龄相关的组成部分，这可能表明每个组成部分的危险因素不同。两个组成部分的风险趋势都遵循有组织筛查的效果。此外，与早期年龄成分相关的风险与致癌 HPV 感染和其他性传播疾病以及吸烟习惯等危险因素的变化有关。
宫颈癌的发病率有两个与年龄相关的组成部分，这些组成部分的病因可能不同。
