Cervical Cancer Incidence Among Elderly Women in Massachusetts Compared With Younger Women.
Cervical Cancer Incidence Among Elderly Women in Massachusetts Compared With Younger Women.
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DOI：
10.1097/lgt.0000000000000435
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发表时间：
2018-10
影响因子：
3.7
通讯作者：
Perkins RB
中科院分区：
文献类型：
--
作者：
Feldman S;Cook E;Davis M;Gershman ST;Hanchate A;Haas JS;Perkins RB
目前的癌症筛查指南建议大多数妇女在65岁时停止宫颈癌筛查。为了检查老年妇女的剩余风险，我们比较了2004-2015年马萨诸塞州<65岁和≥65岁妇女的宫颈癌发病率。使用马萨诸塞州癌症登记处（MCR）来确定2004年1月1日至2015年12月31日期间诊断为宫颈癌的所有妇女。肿瘤发病率根据诊断年龄计算（<65 vs.≥65）。在马萨诸塞州，2004年至2014年诊断出2,418例宫颈癌，其中571例（23.6%）在65岁及以上的女性中被诊断出来。与65岁以下诊断的女性相比，≥65岁诊断的女性更有可能被诊断为II期或更高（71.8%比43.8%,p < 0.001）。2004-2015年，65岁以下妇女的宫颈癌发病率逐年下降。在≥65岁的女性中，2004-2013年癌症发病率每年下降3.9% (p=0.0009)，但2013-2015年呈上升趋势（APC + 14.1%, p=0.12）。在马萨诸塞州，65岁及以上的妇女占宫颈癌诊断的四分之一，并且比年轻妇女处于更高的阶段。即将计划修订的筛查和预防指南应解决老年妇女继续患宫颈癌的风险。从2004年到2015年，65岁以下的妇女占宫颈癌患者的23.6%，并且患有晚期疾病。
Current cancer screening guidelines recommend cessation of cervical cancer screening at age 65 for most women. To examine residual risk among elderly women, we compared cervical cancer incidence rates in Massachusetts from 2004–2015 among women aged <65 vs. ≥65. The Massachusetts Cancer Registry (MCR) was used to identify all women diagnosed with cervical cancer between 1/1/2004–12/31/2015. Cancer incidence was calculated based on age of diagnosis (<65 vs. ≥65). In Massachusetts, 2,418 incident cases of cervical cancer were diagnosed from 2004–2014, of which 571 (23.6%) were diagnosed among women ages 65 and older. When compared with women diagnosed under age 65, women diagnosed at age ≥65 were more likely to be diagnosed with Stage II or higher (71.8% vs. 43.8%, p < 0.001). Cervical cancer incidence rates decreased annually for women <65 from 2004–2015. Among women aged ≥65, cancer incidence rates decreased by 3.9% annually from 2004–2013 (p=0.0009), but 2013–2015 showed an increasing trend (APC + 14.1%, p=0.12). Women 65 and over account for one quarter of cervical cancer diagnoses in Massachusetts, and present with higher stage disease than younger women. Upcoming planned revisions in screening and prevention guidelines should address the continued risk of cervical cancer for older women. From 2004–2015, women age >65 represented 23.6% of cervical cancers and had later stage disease.