移民女性宫颈癌的差异影响:意大利马尔凯地区长达十年的流行病学研究
Differential impact of cervical cancer in immigrant women: a decade-long epidemiological study in the Marche Region, Italy.
作者信息
Di Biagio Katiuscia, Bracci Raffaella, Peconi Chiara, Gasperini Beatrice, Manasse Sonia, Pompili Marco, Sarti Donatella, Lanari Alice, Prospero Emilia
机构信息
Dipartimento di Scienze Biomediche e Sanità Pubblica, Università Politecnica delle Marche, Ancona, Italy.
Agenzia Regionale per la Protezione Ambientale delle Marche, Ancona, Italy.
出版信息
J Epidemiol Community Health. 2025 May 9;79(6):410-415. doi: 10.1136/jech-2024-222564.
BACKGROUND
Cervical cancer is primarily caused by persistent human papilloma virus (HPV) infections, with significant disparities observed in its burden, especially affecting immigrant populations from high HPV prevalence regions. This study evaluates the incidence and severity of cervical cancer in immigrant women in the Marche region, Italy, from 2010 to 2019.
METHODS
We employed a detailed analysis of population-based data from the Marche Cancer Registry using the age-standardised incidence rates (IRs) and Poisson regression models for in situ cervical cancer (ISCC) and infiltrating cervical cancer (ICC).
RESULTS
The IRs for ICC and ISCC among immigrant women are alarmingly higher compared with their Italian counterparts; IR for ICC in immigrant women is 26.5 per 100 000 women-years, compared with 7.9 in Italian women. For ISCC, the IR is 55.1 for immigrants versus 29.2 for Italians.Immigrant women showed a median age at diagnosis for ICC of 49 years, almost a decade younger than Italian women, and they were more likely to have squamous cell histology, which is linked to high-risk HPV strains.
CONCLUSIONS
The study reveals a substantially higher incidence of both ISCC and ICC among immigrant women with ICC diagnosed 8 years previously. These findings underscore the pressing need for culturally and linguistically tailored public health interventions, including improved access to screening and vaccination for HPV, to address the elevated risk and earlier onset of cervical cancer in immigrant women in Italy. The study highlights the critical role of preventive measures in reducing health disparities and enhancing the efficacy of public health policies.
背景
宫颈癌主要由持续性人乳头瘤病毒(HPV)感染引起,其负担存在显著差异,尤其影响来自HPV高流行地区的移民人群。本研究评估了2010年至2019年意大利马尔凯地区移民妇女宫颈癌的发病率和严重程度。
方法
我们对马尔凯癌症登记处基于人群的数据进行了详细分析,使用年龄标准化发病率(IRs)以及原位宫颈癌(ISCC)和浸润性宫颈癌(ICC)的泊松回归模型。
结果
与意大利女性相比,移民女性中ICC和ISCC的IRs高得惊人;移民女性中ICC的IR为每100 000妇女年26.5例,而意大利女性为7.9例。对于ISCC,移民的IR为55.1,而意大利人为29.2。移民女性ICC诊断时的中位年龄为49岁,比意大利女性小近十岁,且她们更有可能为鳞状细胞组织学,这与高危HPV毒株有关。
结论
该研究显示,移民女性中ISCC和ICC的发病率均显著更高,且ICC的诊断时间比意大利女性早8年。这些发现凸显了迫切需要开展针对文化和语言的公共卫生干预措施,包括改善HPV筛查和疫苗接种的可及性,以应对意大利移民女性中宫颈癌风险升高和发病较早的问题。该研究强调了预防措施在减少健康差距和提高公共卫生政策效力方面的关键作用。