Second Department of Gynaecological Oncology, St. John's Cancer Centre of Lublin, ul. Jaczewskiego 7, 20-090, Lublin, Poland.
Department of Cancer Prevention, The Maria Sklodowska-Curie Memorial Cancer Centre and Institute of Oncology, ul. Wilhelma Konrada Roentgena 5, 02-781, Warsaw, Poland.
Eur J Epidemiol. 2017 Jun;32(6):529-532. doi: 10.1007/s10654-017-0291-6. Epub 2017 Aug 5.
Aside from existing opportunistic screening, an organised screening programme (OSP) for cervical cancer (CC) was implemented in 2006/2007 in Poland. We applied joinpoint regression and age-period-cohort model to look for the impact of the OSP on CC incidence/mortality trends. Decline of age-standardised incidence rates (ASIRs) in the screening-age group (25-59 years) accelerated from -2.2% (95% CI -2.7 to -1.7%) between 1993 and 2008 to -6.1% (95% CI -7.7 to -4.4%) annually after 2008. In women aged 60+ years, ASIRs declined from 1986 until 2005 [annual percent change (APC) = -2.6%, 95% CI -2.9 to -2.4%] and stabilised thereafter. Decline of age-standardised mortality rates (ASMRs) in the screening-age group accelerated from -1.3% (95% CI -1.5 to -1.1%) between 1980 and 2005 to -4.7% (95% CI -5.6 to -3.8%) annually after 2005. In women aged 60+ ASMR declined between 1991 and 2004 (APC = -2.9%, 95% CI -3.5 to -2.3%) and stabilised thereafter. Relative risks of CC diagnosis and death were 0.63 (95% CI 0.62-0.65) and 0.61 (95% CI 0.59-0.63), respectively, for the most recent period compared to the reference around 1982. Implementation of the OSP possibly accelerated downward trends in the burden of CC in Polish women under the age of 60, but recent stabilisation of trends in older women requires actions.
除了现有的机会性筛查外，波兰于 2006/2007 年实施了一项针对宫颈癌（CC）的有组织筛查计划（OSP）。我们应用联合点回归和年龄-时期-队列模型来研究 OSP 对 CC 发病率/死亡率趋势的影响。筛查年龄组（25-59 岁）的年龄标准化发病率（ASIR）下降速度从 1993 年至 2008 年的-2.2%（95%CI -2.7 至-1.7%）加速至 2008 年后的每年-6.1%（95%CI -7.7 至-4.4%）。60 岁以上女性的 ASIR 从 1986 年下降到 2005 年[每年百分比变化（APC）=-2.6%，95%CI -2.9 至-2.4%]，此后稳定下来。筛查年龄组的年龄标准化死亡率（ASMR）下降速度从 1980 年至 2005 年的-1.3%（95%CI -1.5 至-1.1%）加速至 2005 年后的每年-4.7%（95%CI -5.6 至-3.8%）。60 岁以上女性的 ASMR 在 1991 年至 2004 年期间下降（APC=-2.9%，95%CI -3.5 至-2.3%），此后稳定下来。与 1982 年左右的参考期相比，最近时期 CC 诊断和死亡的相对风险分别为 0.63（95%CI 0.62-0.65）和 0.61（95%CI 0.59-0.63）。OSP 的实施可能加速了波兰 60 岁以下女性 CC 负担的下降趋势，但最近老年女性趋势的稳定需要采取行动。
