Trends in cancer of the cervix uteri in Sweden following cytological screening

Br J Cancer. 1999 Sep;81(1):159-66. doi: 10.1038/sj.bjc.6690666.


Trends in cervical cancer incidence following the introduction of screening have mostly been studied using cross-sectional data and not analysed separately for squamous cell cancer and adenocarcinomas. Using Swedish nationwide data on incidence and mortality, we analysed trends during more than 3 decades and fitted Poisson-based age-period-cohort models, and also investigated whether screening has reduced the incidence of adenocarcinomas of the cervix. The incidence of reported cancer in situ increased rapidly during 1958-1967. Incidence rates of squamous cell cancer, fairly stable before 1968, decreased thereafter by 4-6% yearly in women aged 40-64, with a much smaller magnitude in younger and older women. An age-cohort model indicated a stable 70-75% reduction in incidence for women born 1940 and later compared with those born around 1923. The incidence of adenocarcinomas doubled during the 35-year study period. The mortality rate increased by 3.6% before 1968 and decreased by 4.0% yearly thereafter. Although a combination of organized and opportunistic screening can reduce the incidence of squamous cell cancer substantially, the incidence of adenocarcinomas appears uninfluenced by screening.

MeSH terms

  • Adenocarcinoma / epidemiology*
  • Adenocarcinoma / mortality
  • Adenocarcinoma / prevention & control
  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoma in Situ / epidemiology
  • Carcinoma in Situ / mortality
  • Carcinoma in Situ / prevention & control
  • Carcinoma, Squamous Cell / epidemiology*
  • Carcinoma, Squamous Cell / mortality
  • Carcinoma, Squamous Cell / prevention & control
  • Cohort Studies
  • Female
  • Humans
  • Incidence
  • Mass Screening / trends*
  • Middle Aged
  • Poisson Distribution
  • Sweden / epidemiology
  • Uterine Cervical Neoplasms / epidemiology*
  • Uterine Cervical Neoplasms / mortality
  • Uterine Cervical Neoplasms / prevention & control