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Cancer Causes & Control
Published in: Cancer Causes & Control 5/2014

01-05-2014 | Original paper

Population-based surveillance for cervical cancer precursors in three central cancer registries, United States 2009

Authors: Elaine W. Flagg, S. Deblina Datta, Mona Saraiya, Elizabeth R. Unger, Edward Peters, Lauren Cole, Vivien W. Chen, Thomas Tucker, Mary Jane Byrne, Glenn Copeland, Won Silva, Meg Watson, Hillard Weinstock

Published in: Cancer Causes & Control | Issue 5/2014

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Abstract

Purpose

The USA has a well-established network of central cancer registries (CCRs) that collect data using standardized definitions and protocols to provide population-based estimates of cancer incidence. The addition of cervical cancer precursors in select CCR operations would facilitate future studies measuring the population-level impact of human papillomavirus (HPV) vaccine. To assess the feasibility of collecting data on cervical cancer precursors, we conducted a multi-site surveillance study in three state-wide CCRs, to obtain annual case counts and compare rates of precursor lesions to those for invasive cervical cancer.

Methods

We developed standardized methods for case identification, data collection and transmission, training and quality assurance, while allowing for registry-specific strategies to accomplish surveillance objectives. We then conducted population-based surveillance for precancerous cervical lesions in three states using the protocols.

Results

We identified 5,718 cases of cervical cancer precursors during 2009. Age-adjusted incidence of cervical cancer precursors was 77 (Kentucky), 60 (Michigan), and 54 (Louisiana) per 100,000 women. Highest rates were observed in those aged 20–29 years: 274 (Kentucky), 202 (Michigan), and 196 (Louisiana) per 100,000. The variable with the most missing data was race/ethnicity, which was missing for 13 % of cases in Kentucky, 18 % in Michigan, and 1 % in Louisiana. Overall rates of cervical cancer precursors were over sixfold higher than invasive cervical cancer rates [rate ratios: 8.6 (Kentucky), 8.3 (Michigan), and 6.2 (Louisiana)].

Conclusions

Incorporating surveillance of cervical cancer precursors using existing CCR infrastructure is feasible and results in collection of population-based incidence data. Standardized collection of these data in high-quality registry systems will be useful in future activities monitoring the impact of HPV vaccination across states. As a result of this study, ongoing surveillance of these lesions has now been conducted in four CCRs since 2010.
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Metadata
Title
Population-based surveillance for cervical cancer precursors in three central cancer registries, United States 2009
Authors
Elaine W. Flagg
S. Deblina Datta
Mona Saraiya
Elizabeth R. Unger
Edward Peters
Lauren Cole
Vivien W. Chen
Thomas Tucker
Mary Jane Byrne
Glenn Copeland
Won Silva
Meg Watson
Hillard Weinstock
Publication date
01-05-2014
Publisher
Springer International Publishing
Published in
Cancer Causes & Control / Issue 5/2014
Print ISSN: 0957-5243
Electronic ISSN: 1573-7225
DOI
https://doi.org/10.1007/s10552-014-0362-x

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