The end of the decline in cervical cancer mortality in Spain: trends across the period 1981-2012

BACKGROUND: In Spain, cervical cancer prevention is based on opportunistic screening, due to the disease's traditionally low incidence and mortality rates. Changes in sexual behaviour, tourism and migration have, however, modified the probability of exposure to human papilloma virus among Spani...

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Authors: Cervantes-Amat, Marta, Lopez-Abente, Gonzalo, Aragones, Nuria, Pollan-Santamaria, Marina, Pastor-Barriuso, Roberto, Perez-Gomez, Beatriz
Format: article
Publication Date:2015
Country:España
Institution:Instituto de Salud Carlos III (ISCIII)
Repository:Repisalud
Language:English
OAI Identifier:oai:repisalud.isciii.es:20.500.12105/8969
Online Access:http://hdl.handle.net/20.500.12105/8969
Access Level:Open access
Keyword:Adolescent
Adult
Female
Humans
Middle Aged
Papillomaviridae
Spain
Uterine Cervical Neoplasms
Young Adult
Mass Screening
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spelling The end of the decline in cervical cancer mortality in Spain: trends across the period 1981-2012Cervantes-Amat, MartaLopez-Abente, GonzaloAragones, NuriaPollan-Santamaria, MarinaPastor-Barriuso, RobertoPerez-Gomez, BeatrizAdolescentAdultFemaleHumansMiddle AgedPapillomaviridaeSpainUterine Cervical NeoplasmsYoung AdultMass ScreeningBACKGROUND: In Spain, cervical cancer prevention is based on opportunistic screening, due to the disease's traditionally low incidence and mortality rates. Changes in sexual behaviour, tourism and migration have, however, modified the probability of exposure to human papilloma virus among Spaniards. This study thus sought to evaluate recent cervical cancer mortality trends in Spain. METHODS: We used annual female population figures and individual records of deaths certified as cancer of cervix, reclassifying deaths recorded as unspecified uterine cancer to correct coding quality problems. Joinpoint models were fitted to estimate change points in trends, as well as the annual (APC) and average annual percentage change. Log-linear Poisson models were also used to study age-period-cohort effects on mortality trends and their change points. RESULTS: 1981 marked the beginning of a decline in cervical cancer mortality (APC(1981-2003): -3.2; 95% CI:-3.4;-3.0) that ended in 2003, with rates reaching a plateau in the last decade (APC2003-2012: 0.1; 95% CI:-0.9; 1.2). This trend, which was observable among women aged 45-46 years (APC(2003-2012): 1.4; 95% CI:-0.1;2.9) and over 65 years (APC(2003-2012): -0.1; 95% CI:-1.9;1.7), was clearest in Spain's Mediterranean and Southern regions. CONCLUSIONS: The positive influence of opportunistic screening is not strong enough to further reduce cervical cancer mortality rates in the country. Our results suggest that the Spanish Health Authorities should reform current prevention programmes and surveillance strategies in order to confront the challenges posed by cervical cancer.BioMed Central (BMC)Instituto de Salud Carlos III20202020-01-2920152015-04-1520152015-04-15journal articlehttp://purl.org/coar/resource_type/c_6501VoRhttp://purl.org/coar/version/c_970fb48d4fbd8a85info:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/20.500.12105/8969reponame:Repisaludinstname:Instituto de Salud Carlos III (ISCIII)InglésengES FIS PI11 00871open accesshttp://purl.org/coar/access_right/c_abf2Atribución 4.0 Internacionalhttp://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:repisalud.isciii.es:20.500.12105/89692026-06-12T12:43:37Z
dc.title.none.fl_str_mv The end of the decline in cervical cancer mortality in Spain: trends across the period 1981-2012
title The end of the decline in cervical cancer mortality in Spain: trends across the period 1981-2012
spellingShingle The end of the decline in cervical cancer mortality in Spain: trends across the period 1981-2012
Cervantes-Amat, Marta
Adolescent
Adult
Female
Humans
Middle Aged
Papillomaviridae
Spain
Uterine Cervical Neoplasms
Young Adult
Mass Screening
title_short The end of the decline in cervical cancer mortality in Spain: trends across the period 1981-2012
title_full The end of the decline in cervical cancer mortality in Spain: trends across the period 1981-2012
title_fullStr The end of the decline in cervical cancer mortality in Spain: trends across the period 1981-2012
title_full_unstemmed The end of the decline in cervical cancer mortality in Spain: trends across the period 1981-2012
title_sort The end of the decline in cervical cancer mortality in Spain: trends across the period 1981-2012
dc.creator.none.fl_str_mv Cervantes-Amat, Marta
Lopez-Abente, Gonzalo
Aragones, Nuria
Pollan-Santamaria, Marina
Pastor-Barriuso, Roberto
Perez-Gomez, Beatriz
author Cervantes-Amat, Marta
author_facet Cervantes-Amat, Marta
Lopez-Abente, Gonzalo
Aragones, Nuria
Pollan-Santamaria, Marina
Pastor-Barriuso, Roberto
Perez-Gomez, Beatriz
author_role author
author2 Lopez-Abente, Gonzalo
Aragones, Nuria
Pollan-Santamaria, Marina
Pastor-Barriuso, Roberto
Perez-Gomez, Beatriz
author2_role author
author
author
author
author
dc.contributor.none.fl_str_mv Instituto de Salud Carlos III
dc.subject.none.fl_str_mv Adolescent
Adult
Female
Humans
Middle Aged
Papillomaviridae
Spain
Uterine Cervical Neoplasms
Young Adult
Mass Screening
topic Adolescent
Adult
Female
Humans
Middle Aged
Papillomaviridae
Spain
Uterine Cervical Neoplasms
Young Adult
Mass Screening
description BACKGROUND: In Spain, cervical cancer prevention is based on opportunistic screening, due to the disease's traditionally low incidence and mortality rates. Changes in sexual behaviour, tourism and migration have, however, modified the probability of exposure to human papilloma virus among Spaniards. This study thus sought to evaluate recent cervical cancer mortality trends in Spain. METHODS: We used annual female population figures and individual records of deaths certified as cancer of cervix, reclassifying deaths recorded as unspecified uterine cancer to correct coding quality problems. Joinpoint models were fitted to estimate change points in trends, as well as the annual (APC) and average annual percentage change. Log-linear Poisson models were also used to study age-period-cohort effects on mortality trends and their change points. RESULTS: 1981 marked the beginning of a decline in cervical cancer mortality (APC(1981-2003): -3.2; 95% CI:-3.4;-3.0) that ended in 2003, with rates reaching a plateau in the last decade (APC2003-2012: 0.1; 95% CI:-0.9; 1.2). This trend, which was observable among women aged 45-46 years (APC(2003-2012): 1.4; 95% CI:-0.1;2.9) and over 65 years (APC(2003-2012): -0.1; 95% CI:-1.9;1.7), was clearest in Spain's Mediterranean and Southern regions. CONCLUSIONS: The positive influence of opportunistic screening is not strong enough to further reduce cervical cancer mortality rates in the country. Our results suggest that the Spanish Health Authorities should reform current prevention programmes and surveillance strategies in order to confront the challenges posed by cervical cancer.
publishDate 2015
dc.date.none.fl_str_mv 2015
2015-04-15
2015
2015-04-15
2020
2020-01-29
dc.type.none.fl_str_mv journal article
http://purl.org/coar/resource_type/c_6501
VoR
http://purl.org/coar/version/c_970fb48d4fbd8a85
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv http://hdl.handle.net/20.500.12105/8969
url http://hdl.handle.net/20.500.12105/8969
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.relation.none.fl_str_mv ES FIS PI11 00871
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
Atribución 4.0 Internacional
http://creativecommons.org/licenses/by/4.0/
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
Atribución 4.0 Internacional
http://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv BioMed Central (BMC)
publisher.none.fl_str_mv BioMed Central (BMC)
dc.source.none.fl_str_mv reponame:Repisalud
instname:Instituto de Salud Carlos III (ISCIII)
instname_str Instituto de Salud Carlos III (ISCIII)
reponame_str Repisalud
collection Repisalud
repository.name.fl_str_mv
repository.mail.fl_str_mv
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score 15,81155

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