The temporal and age-dependent patterns of hysterectomy-corrected cervical cancer incidence rates in Denmark

a population-based cohort study

Anne Hammer, Johnny Kahlert, Anne Rositch, Lars Pedersen, Patti Gravitt, Jan Blaakaer, Mette Soegaard

Research output: Contribution to journalArticle

Abstract

Introduction: Hysterectomy is a common gynecological procedure; however, the incidence of total and subtotal hysterectomy varies across countries, by age, and over time. As only women with an intact cervix are at risk of cervical cancer, failing to remove hysterectomized women from the denominator may underestimate the cervical cancer incidence. We aimed to describe the temporal and age-dependent patterns of cervical cancer incidence in Denmark before and after correction for hysterectomy. Material and methods: Using data from national registries we calculated uncorrected and hysterectomy-corrected cervical cancer incidence rates among women ≥20 years during 2000–11. Hysterectomy-corrected rates were calculated by subtracting post-hysterectomy person-years from the denominator. Results: The overall uncorrected cervical cancer incidence rate was 17.8/100 000 person-years (95% CI 17.3–18.3). After correction for hysterectomy, the rate increased by 8.4% to 19.3/100 000 person-years (95% CI 18.8–19.9). The highest uncorrected incidence was seen in women aged 35–39 years, peaking at 24.4/100 000 person-years, whereas the highest hysterectomy-corrected cervical cancer incidence rate was observed in women aged 75–79 years (29.4/100 000 person-years). Over time, women ≥60 years had the highest hysterectomy-corrected cervical cancer incidence. Conclusions: Correcting for hysterectomy incidence resulted in a higher cervical cancer incidence and a shift in the peak incidence from age 35–39 years to age 75–79 years. Over time, women ≥60 years were at the highest risk of cervical cancer. Given the high incidence in women >60–65 years, when women are eligible to exit screening, a revision of the screening guidelines may be warranted.

Original languageEnglish (US)
Pages (from-to)150-157
Number of pages8
JournalActa Obstetricia et Gynecologica Scandinavica
Volume96
Issue number2
DOIs
StatePublished - Feb 1 2017

Fingerprint

Denmark
Hysterectomy
Uterine Cervical Neoplasms
Cohort Studies
Incidence
Population
Cervix Uteri
Registries
Guidelines

Keywords

  • Cervical cancer
  • cervical cancer screening
  • epidemiology
  • hysterectomy incidence

ASJC Scopus subject areas

  • Obstetrics and Gynecology

Cite this

The temporal and age-dependent patterns of hysterectomy-corrected cervical cancer incidence rates in Denmark : a population-based cohort study. / Hammer, Anne; Kahlert, Johnny; Rositch, Anne; Pedersen, Lars; Gravitt, Patti; Blaakaer, Jan; Soegaard, Mette.

In: Acta Obstetricia et Gynecologica Scandinavica, Vol. 96, No. 2, 01.02.2017, p. 150-157.

Research output: Contribution to journalArticle

Hammer, Anne ; Kahlert, Johnny ; Rositch, Anne ; Pedersen, Lars ; Gravitt, Patti ; Blaakaer, Jan ; Soegaard, Mette. / The temporal and age-dependent patterns of hysterectomy-corrected cervical cancer incidence rates in Denmark : a population-based cohort study. In: Acta Obstetricia et Gynecologica Scandinavica. 2017 ; Vol. 96, No. 2. pp. 150-157.
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abstract = "Introduction: Hysterectomy is a common gynecological procedure; however, the incidence of total and subtotal hysterectomy varies across countries, by age, and over time. As only women with an intact cervix are at risk of cervical cancer, failing to remove hysterectomized women from the denominator may underestimate the cervical cancer incidence. We aimed to describe the temporal and age-dependent patterns of cervical cancer incidence in Denmark before and after correction for hysterectomy. Material and methods: Using data from national registries we calculated uncorrected and hysterectomy-corrected cervical cancer incidence rates among women ≥20 years during 2000–11. Hysterectomy-corrected rates were calculated by subtracting post-hysterectomy person-years from the denominator. Results: The overall uncorrected cervical cancer incidence rate was 17.8/100 000 person-years (95{\%} CI 17.3–18.3). After correction for hysterectomy, the rate increased by 8.4{\%} to 19.3/100 000 person-years (95{\%} CI 18.8–19.9). The highest uncorrected incidence was seen in women aged 35–39 years, peaking at 24.4/100 000 person-years, whereas the highest hysterectomy-corrected cervical cancer incidence rate was observed in women aged 75–79 years (29.4/100 000 person-years). Over time, women ≥60 years had the highest hysterectomy-corrected cervical cancer incidence. Conclusions: Correcting for hysterectomy incidence resulted in a higher cervical cancer incidence and a shift in the peak incidence from age 35–39 years to age 75–79 years. Over time, women ≥60 years were at the highest risk of cervical cancer. Given the high incidence in women >60–65 years, when women are eligible to exit screening, a revision of the screening guidelines may be warranted.",
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T1 - The temporal and age-dependent patterns of hysterectomy-corrected cervical cancer incidence rates in Denmark

T2 - a population-based cohort study

AU - Hammer, Anne

AU - Kahlert, Johnny

AU - Rositch, Anne

AU - Pedersen, Lars

AU - Gravitt, Patti

AU - Blaakaer, Jan

AU - Soegaard, Mette

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N2 - Introduction: Hysterectomy is a common gynecological procedure; however, the incidence of total and subtotal hysterectomy varies across countries, by age, and over time. As only women with an intact cervix are at risk of cervical cancer, failing to remove hysterectomized women from the denominator may underestimate the cervical cancer incidence. We aimed to describe the temporal and age-dependent patterns of cervical cancer incidence in Denmark before and after correction for hysterectomy. Material and methods: Using data from national registries we calculated uncorrected and hysterectomy-corrected cervical cancer incidence rates among women ≥20 years during 2000–11. Hysterectomy-corrected rates were calculated by subtracting post-hysterectomy person-years from the denominator. Results: The overall uncorrected cervical cancer incidence rate was 17.8/100 000 person-years (95% CI 17.3–18.3). After correction for hysterectomy, the rate increased by 8.4% to 19.3/100 000 person-years (95% CI 18.8–19.9). The highest uncorrected incidence was seen in women aged 35–39 years, peaking at 24.4/100 000 person-years, whereas the highest hysterectomy-corrected cervical cancer incidence rate was observed in women aged 75–79 years (29.4/100 000 person-years). Over time, women ≥60 years had the highest hysterectomy-corrected cervical cancer incidence. Conclusions: Correcting for hysterectomy incidence resulted in a higher cervical cancer incidence and a shift in the peak incidence from age 35–39 years to age 75–79 years. Over time, women ≥60 years were at the highest risk of cervical cancer. Given the high incidence in women >60–65 years, when women are eligible to exit screening, a revision of the screening guidelines may be warranted.

AB - Introduction: Hysterectomy is a common gynecological procedure; however, the incidence of total and subtotal hysterectomy varies across countries, by age, and over time. As only women with an intact cervix are at risk of cervical cancer, failing to remove hysterectomized women from the denominator may underestimate the cervical cancer incidence. We aimed to describe the temporal and age-dependent patterns of cervical cancer incidence in Denmark before and after correction for hysterectomy. Material and methods: Using data from national registries we calculated uncorrected and hysterectomy-corrected cervical cancer incidence rates among women ≥20 years during 2000–11. Hysterectomy-corrected rates were calculated by subtracting post-hysterectomy person-years from the denominator. Results: The overall uncorrected cervical cancer incidence rate was 17.8/100 000 person-years (95% CI 17.3–18.3). After correction for hysterectomy, the rate increased by 8.4% to 19.3/100 000 person-years (95% CI 18.8–19.9). The highest uncorrected incidence was seen in women aged 35–39 years, peaking at 24.4/100 000 person-years, whereas the highest hysterectomy-corrected cervical cancer incidence rate was observed in women aged 75–79 years (29.4/100 000 person-years). Over time, women ≥60 years had the highest hysterectomy-corrected cervical cancer incidence. Conclusions: Correcting for hysterectomy incidence resulted in a higher cervical cancer incidence and a shift in the peak incidence from age 35–39 years to age 75–79 years. Over time, women ≥60 years were at the highest risk of cervical cancer. Given the high incidence in women >60–65 years, when women are eligible to exit screening, a revision of the screening guidelines may be warranted.

KW - Cervical cancer

KW - cervical cancer screening

KW - epidemiology

KW - hysterectomy incidence

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