Mangone Lucia, Marinelli Francesco, Bisceglia Isabella, Roncaglia Francesca, Mastrofilippo Valentina, Morabito Fortunato, Neri Antonino, Aguzzoli Lorenzo, Mandato Vincenzo Dario
Epidemiology Unit, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, I-42122 Reggio Emilia, Italy.
Unit of Obstetrics and Gynaecology, Azienda Unità Sanitaria Locale-IRCCS di Reggio Emilia, I-42122 Reggio Emilia, Italy.
Mol Clin Oncol. 2024 Aug 2;21(4):71. doi: 10.3892/mco.2024.2770. eCollection 2024 Oct.
While cervical cancer is relatively uncommon in Western countries, it continues to pose significant concern due to its high mortality rates. Intraepithelial forms [cervical intraepithelial neoplasia (CIN) 2 and CIN 3] are more prevalent in regions with comprehensive screening coverage, particularly in areas that use the Papanicolaou test and HPV detection. The present study aims to characterize the trends of precancerous lesions and infiltrating tumors over a decade, assessing survival rates by age, stage and country of origin. A total of 1,752 CIN 2/3 lesions and 152 infiltrating cancers were recorded in the Reggio Emilia Cancer Registry between January 2008 and December 2018. A clear increase in CIN 2/3 lesions was observed over the years while infiltrating tumors remained rare and the numbers of cancer cases declined. The 5-year survival rate was found to be 67%, with survival closely correlated with stage (88, 82, 74 and 12% for stages I, II, III and IV, respectively) and age (84, 80 and 37% for ages <40, 40-65 and 65+, respectively). Multivariable analysis confirmed an excess risk for advanced stages III (HR 3.1; 95% CI, 1.3-7.3) and IV (HR 19.6; 95% CI, 8.2-46.7), as well as in women 65+ (HR 2.8; 95% CI, 1.0-8.1). Analysis of national origins revealed comparable stage distribution for Italians and non-Italians at stage I (41 vs. 47%), while a notable disparity emerged for stage IV (28 vs. 6%). This difference could be attributed to the average age of Italians compared to non-Italians (59 vs. 49 years). Overall, the present study underscored the importance of continued surveillance and intervention strategies targeting advanced-stage disease, particularly in older populations and among non-Italian patients. Efforts to enhance screening coverage and access to timely interventions remain critical in reducing the burden of cervical cancer and improving survival outcomes.
虽然宫颈癌在西方国家相对不常见，但由于其高死亡率，仍然令人高度关注。上皮内病变形式[宫颈上皮内瘤变（CIN）2和CIN 3]在筛查覆盖率高的地区更为普遍，特别是在使用巴氏试验和HPV检测的地区。本研究旨在描述癌前病变和浸润性肿瘤在十年间的趋势，按年龄、分期和原籍国评估生存率。2008年1月至2018年12月期间，雷焦艾米利亚癌症登记处共记录了1752例CIN 2/3病变和152例浸润性癌症。多年来观察到CIN 2/3病变明显增加，而浸润性肿瘤仍然罕见，癌症病例数量下降。发现5年生存率为67%，生存率与分期（I、II、III和IV期分别为88%、82%、74%和12%）和年龄（年龄<40岁、40 - 65岁和65岁以上分别为84%、80%和37%）密切相关。多变量分析证实III期（HR 3.1；95% CI，1.3 - 7.3）和IV期（HR 19.6；95% CI，8.2 - 46.7）以及65岁以上女性（HR 2.8；95% CI，1.0 - 8.1）存在更高风险。对原籍国的分析显示，意大利人和非意大利人在I期的分期分布相当（41%对47%），而IV期则出现显著差异（28%对6%）。这种差异可能归因于意大利人与非意大利人的平均年龄（59岁对49岁）。总体而言，本研究强调了针对晚期疾病持续监测和干预策略的重要性，特别是在老年人群和非意大利患者中。加强筛查覆盖率和及时获得干预措施的努力对于减轻宫颈癌负担和改善生存结果仍然至关重要。
