Cancer Causes & Control

, Volume 25, Issue 5, pp 571–581

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

Authors

    • Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB PreventionCenters for Disease Control and Prevention
  • S. Deblina Datta
    • Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB PreventionCenters for Disease Control and Prevention
  • Mona Saraiya
    • Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health PromotionCenters for Disease Control and Prevention
  • Elizabeth R. Unger
    • Division of High-Consequence Pathogens and Pathology, National Center for Emerging and Zoonotic Infectious DiseasesCenters for Disease Control and Prevention
  • Edward Peters
    • Louisiana Tumor Registry, Epidemiology Program, School of Public HealthLouisiana State University Health Sciences Center
  • Lauren Cole
    • Louisiana Tumor Registry, Epidemiology Program, School of Public HealthLouisiana State University Health Sciences Center
  • Vivien W. Chen
    • Louisiana Tumor Registry, Epidemiology Program, School of Public HealthLouisiana State University Health Sciences Center
  • Thomas Tucker
    • Kentucky Cancer Registry, Markey Cancer Control Program, Markey Cancer CenterUniversity of Kentucky
  • Mary Jane Byrne
    • Kentucky Cancer Registry, Markey Cancer Control Program, Markey Cancer CenterUniversity of Kentucky
  • Glenn Copeland
    • Michigan Cancer Surveillance ProgramMichigan Department of Community Health
  • Won Silva
    • Michigan Cancer Surveillance ProgramMichigan Department of Community Health
  • Meg Watson
    • Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health PromotionCenters for Disease Control and Prevention
  • Hillard Weinstock
    • Division of STD Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB PreventionCenters for Disease Control and Prevention
Original paper

DOI: 10.1007/s10552-014-0362-x

Cite this article as:
Flagg, E.W., Datta, S.D., Saraiya, M. et al. Cancer Causes Control (2014) 25: 571. doi:10.1007/s10552-014-0362-x

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.

Keywords

Cervical intraepithelial neoplasiaEpidemiologyPublic healthPopulation characteristicsSexually transmitted diseases

Copyright information

© Springer International Publishing Switzerland (outside the USA) 2014