Trends in Invasive Cervical Cancer Incidence in East Anglia from 1971 to 1993

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Abstract
Objective—: To study the trends in the incidence of invasive cervical cancer in East Anglia. Design—: Statistical analysis of age specific incidence rate for the period 1971–93 using East Anglian Cancer Registry data. Subjects—: All cases of invasive cervical cancer registered with the East Anglian Cancer registry, diagnosed in the period 1971–93. Main outcome measures—: Changing incidence of cervical cancer. Results—: For the 20 years 1971–90, trends varied widely by district and by age group, with little discernible overall effect of the increasing screening activity. Since 1990, rates have fallen sharply in the age groups targeted for screening, with a reduction of 34% (95% confidence interval 26% to 42%) from that expected based on 1971–90 trends. This fall was preceded by a rapid rise in the national uptake of screening. A shift to more favourable stage at diagnosis has also occurred. Conclusion—: Changes in the organisation and management of the national screening programme introduced in 1988 and 1989 seem to have led to substantial improvements in effectiveness.