Since the prevalence of several risk factors for cervix uteri cancer, such as sexual activity patterns, cigarette smoking, and contraceptive use, has changed over time, the authors analyzed US trends for this cancer during the 1970s to 1980s to search for corresponding variations. Invasive cervical cancer incidence and mortality rates continued to decrease among blacks and whites, although declines are moderating or plateauing among young whites. Carcinoma in situ rates have not changed greatly or have declined, more so among blacks than whites. Excess risks among blacks are less evident among younger than older age groups. Increasing trends were seen only among whites in certain age groups or with certain histologic types. Declining trends in cervical cancer appear related to the widespread use of cervical cytologic screening programs, which have counteracted increases anticipated from changes in risk factor prevalence. Continued surveillance is warranted, however, with special attention to the trends in cervical adenocarcinoma.

Recent trends in cervix uteri cancer

Polynesia consists of several islands that are scattered across a vast triangle in the Pacific, and include New Zealand, Hawaii, and the Pacific islands. There are reported differences in the types of cancer and epidemiologies seen among communities in these islands, the reasons for which are diverse and complex. In this Review, we describe patterns of cancer incidence, mortality, and survival in indigenous populations compared with populations of European origin in Polynesia, and highlight the limited available data for Pacific populations. Additionally, we document the current knowledge of the underlying biology of cancers in these populations, and report risk factors that differ between ethnicities, including smoking, viral infections, and obesity. Disparities in measures of health are highlighted, as are evident differences in knowledge of tumour biology and cancer management between majority and minority populations.

https://www.thelancet.com/pdfs/journals/lanonc/PIIS1470-2045(08)70127-X.pdf

Cancer disparities in indigenous Polynesian populations: Māori, Native Hawaiians, and Pacific people

Objectives To describe the effect of occult invasive disease on progress towards meeting the Health of the Nation target for reducing the incidence of cervical cancer, and to investigate the possible effect of a higher risk of cervical cancer in women born since 1940.Setting Southampton and South West Hampshire (SSWH), with a total female population of 218 549 in 1990, the midpoint of a study period covering 1985 to 1995.Methods Incidence was calculated per 100 000 women years at risk in overlapping three year periods for symptomatic and screen detected cancers. The same method was used for cohorts of women born before and after 1940. Screen detected stage Ia1 cancers were identified as a subgroup.Results The incidence of invasive cervical cancer fell by 27.4%, from 16.8 to 12.2 per 100 000 women years at risk between 1985–87 and 1993–95, which was a significant linear trend (χ2=4.494, df=1, p=0.034). The corresponding figures adjusted for age in a standardised European population were 16.3 and 11.5: a fa...

N.E Day

Papers

Deaths from cervical cancer.