Castanon Alejandra, Tataru Daniela, Sasieni Peter
School of Cancer & Pharmaceutical Sciences, Innovation Hub, Guys Cancer Centre, Guys Hospital, London SE1 9RT, UK.
National Cancer Registration and Analysis Service, Public Health England, London SE1 8UG, UK.
Cancers (Basel). 2020 Jul 28;12(8):2079. doi: 10.3390/cancers12082079.
Age at which women are first invited to attend cervical screening in England has changed twice: in 2004, women under 25 years were no longer invited; and in 2012, first invitations were sent six months earlier (at age 24.5 years). Concomitantly, a dramatic increase in screen-detected cervical cancer was observed, and their survival had not been documented. Diagnoses of invasive cervical cancer at ages 20-29 years in 2006-2016 in England were followed until the end of 2018 for deaths. We estimated 8-year overall survival (OS) by International Federation of Gynecology and Obstetrics (FIGO) stage and age at first screening invitation. Overall and relative survival for stage IA cervical cancer for women diagnosed aged 20-29 years in England ( = 1905) was excellent at 99.8% (95% confidence intervals (CI): 99.4-99.9%) and 100% (95% CI: 99.7-100.1%), respectively. OS for stage IB cervical cancer ( = 1101) was 90.4% (95% CI: 88.3-92.2%). Survival from stage IB was worse for women diagnosed age 20-24 years compared to those diagnosed 25-29 years at diagnosis ( < 0.0001), but no difference was observed by age at first invitation for screening, = 0.8575. OS for stage II (65.5%, 95% CI: 60.2-72.0%) and stage III+ (36.6%, 95% CI 28.4-44.7%) were poorer. Survival from stage I cervical cancer in young women in England is excellent: mortality in women with stage IA cancer is akin to that of the general population regardless of age at first invitation to screening.
在英格兰，首次邀请女性参加宫颈癌筛查的年龄发生过两次变化：2004年，不再邀请25岁以下的女性；2012年，首次邀请时间提前了6个月（在24.5岁时）。与此同时，筛查发现的宫颈癌显著增加，但其生存率尚无记录。对2006 - 2016年英格兰20 - 29岁女性的浸润性宫颈癌诊断情况进行随访，直至2018年底统计死亡情况。我们根据国际妇产科联盟（FIGO）分期和首次筛查邀请时的年龄估算了8年总生存率（OS）。在英格兰，20 - 29岁被诊断为IA期宫颈癌的女性（n = 1905）的总生存率和相对生存率分别为99.8%（95%置信区间（CI）：99.4 - 99.9%）和100%（95% CI：99.7 - 100.1%），非常出色。IB期宫颈癌（n = 1101）的OS为90.4%（95% CI：88.3 - 92.2%）。与诊断时年龄在25 - 29岁的女性相比，诊断时年龄在20 - 24岁的IB期女性的生存率更差（P < 0.0001），但首次筛查邀请时的年龄对生存率无差异（P = 0.8575）。II期（65.5%，95% CI：60.2 - 72.0%）和III期及以上（36.6%，95% CI 28.4 - 44.7%）的OS较差。英格兰年轻女性I期宫颈癌的生存率非常出色：IA期癌症女性的死亡率与一般人群相似，无论首次筛查邀请时的年龄如何。
