Abstract
Purpose
This study describes time trends of cervical cancer and Cervical Intraepithelial Neoplasia 3 (CIN3) in Israel in the years 1986–2010 and characterizes these patients by demographics.
Methods
A retrospective survey based on cervical cancer and CIN3 data documented in the computerized system of the second largest Health Maintenance Organizations (HMO) in Israel, “Maccabi Healthcare Services” (MHS) between 1986 and 2010.
Results
737 cervical cancer patients and 3,459 patients of CIN3 were reported between 1986 and 2010. The mean age of women with cervical cancer was significantly higher (mean 49.1 years) than that of CIN3 patients (mean 36.3 years) (p-value < 0.0001). The annual age-adjusted incidence rate of cervical cancer increased significantly from 1.6 per 100,000 in 1986 to 3.7 per 100,000 in 2010 (p for trend = 0.0001) and for CIN3, from 3.9 per 100,000 in 1986 to 40.4 per 100,000 in 2010 (p for trend = 0.0001). For cervical cancer, using the Joinpoint software we demonstrated an increase in the age-adjusted incidence rate between 1986 and 2003 and since then, a decrease was observed. Cervical cancer and CIN3 were mostly common in the Tel Aviv District.
Conclusions
Although quite low to begin with, the incidence rates of cervical cancer and CIN3 in Israel may be further lowered by implementing an organized screening program and introduction of the HPV vaccine into the national immunization program.
Similar content being viewed by others
References
Globocan 2012. Cervical cancer incidence and mortality worldwide in 2012 summary. Cancer fact sheet. http://globocan.iarc.fr/Pages/fact_sheets_population.aspx. Accessed 29 Dec 2014
Israeli National Cancer Registry, Israeli Center for Disease Control, Ministry of Health. Annual Reports. http://www.health.gov.il/UNITSOFFICE/HD/ICDC/ICR/CANCERINCIDENCE/Pages/about.aspx. Accessed 01 Jan 2015
Michalas SP (2000) The Pap test: George N. Papanicolaou (1883–1962). A screening test for the prevention of cancer of uterine cervix. Eur J Obstet Gynecol Reprod Biol 90:135–138
Cook GA, Draper GJ (1984) Trends in cervical cancer and carcinoma in situ in Great Britain. Br J Cancer 50:367–375
Johannesson G, Geirsson G, Day N (1978) The effect of mass screening in Iceland, 1965–1974, on the incidence and mortality of cervical carcinoma. Int J Cancer 21:418–425
Kitchener HC, Castle PE, Cox JT (2006) Achievements and limitations of cervical cytology screening. Vaccine 24(Suppl 3):S3/63–70
Insinga RP, Glass AG, Rush BB (2004) Diagnoses and outcomes in cervical cancer screening: a population-based study. Am J Obstet Gynecol 191:105–113
Bornstein J, Schejter E (2007) Pap screening in Israel. Ob/Gyn Updat 57:4–6
Schejter E, Bornstein J, Siegler E (2013) Cervical cancer screening, human papillomavirus vaccination practices and current infrastructure in Israel. Vaccine 31(Suppl 8):I42–I45. doi:10.1016/j.vaccine.2012.06.099
Bassal R, Rosin LS, Schvimer M, Schejter E, Ozeryansky B, Kulik S, Bachar R, Shapira H, Sandbank J, Cohen D, Keinan-Boker L (2014) Prevalence and correlates of human papillomavirus genotypes among patients with cervical cancer and cervical intraepithelial neoplasia 3 in Israel. J Low Genit Tract Dis (Epub ahead of print)
Crowe E, Pandeya N, Brotherton JM, Dobson AJ, Kisely S, Lambert SB, Whiteman DC (2014) Effectiveness of quadrivalent human papillomavirus vaccine for the prevention of cervical abnormalities: case–control study nested within a population based screening programme in Australia. BMJ 348:g1458. doi:10.1136/bmj.g1458
Walboomers JM, Jacobs MV, Manos MM, Bosch FX, Kummer JA, Shah KV, Snijders PJ, Peto J, Meijer CJ, Muñoz N (1999) Human papillomavirus is a necessary cause of invasive cervical cancer worldwide. J Pathol 189:12–19
Israeli Social Security. Periodical surveys—Membership in Health Maintenance organizations. https://www.btl.gov.il/Publications/Pages/default.aspx. Accessed 08 Mar 2014
Israel Bureau of Statistics (2006) Characterization and classification of local authorities by the socio-economic level of the population. Table 1, Local Councils and Municipalities - Rank, Cluster Membership, Population, Variable Values, Standardized Values and Ranking for the Variables Used in the Computation of the Index. http://www.cbs.gov.il/publications/local_authorities06/local_authorities_e.htm. Accessed 01 Jan 2015
Joinpoint (2014) Statistical Research and Applications Branch, National Cancer Institute. Joinpoint Regression Program, Version 4.1.1. http://surveillance.cancer.gov/joinpoint. Accessed 14 Sept 2014
Ngelangel C, Muñoz N, Bosch FX, Limson GM, Festin MR, Deacon J, Jacobs MV, Santamaria M, Meijer CJ, Walboomers JM (1998) Causes of cervical cancer in the Philippines: a case–control study. J Natl Cancer Inst 90:43–49
Villa LL (2012) Cervical cancer in Latin America and the Caribbean: the problem and the way to solutions. Cancer Epidemiol Biomarkers Prev. 21:1409–1413. doi:10.1158/1055-9965.EPI-12-0147
Cervical cancer: UK incidence statistics. Cancer Research UK. http://www.cancerresearchuk.org/cancer-info/cancerstats/types/cervix/incidence/uk-cervical-cancer-incidence-statistics. Accessed 08 Mar 2014
Kesic V, Poljak M, Rogovskaya S (2012) Cervical cancer burden and prevention activities in Europe. Cancer Epidemiol Biomarkers Prev 21:1423–1433. doi:10.1158/1055-9965.EPI-12-0181
National Cancer Institute. SEER Stat Fact Sheets: Cervix Uteri. NCI website. http://www.seer.cancer.gov/statfacts/html/cervix.html. Accessed 01 Dec 2014
Hosono S, Kawase T, Matsuo K, Watanabe M, Kajiyama H, Hirose K, Suzuki T, Kidokoro K, Ito H, Nakanishi T, Yatabe Y, Hamajima N, Kikkawa F, Tajima K, Tanaka H (2010) HLA-A alleles and the risk of cervical squamous cell carcinoma in Japanese women. J Epidemiol 20:295–301
Glezerman M, Piura B, Insler V (1989) Cervical cancer in Jewish women. Am J Obstet Gynecol 161:1186–1190
Bray F, Loos AH, McCarron P, Weiderpass E, Arbyn M, Møller H, Hakama M, Parkin DM (2005) Trends in cervical squamous cell carcinoma incidence in 13 European countries: changing risk and the effects of screening. Cancer Epidemiol Biomarkers Prev 14:677–686
Foley G, Alston R, Geraci M, Brabin L, Kitchener H, Birch J (2011) Increasing rates of cervical cancer in young women in England: an analysis of national data 1982–2006. Br J Cancer 105:177–184. doi:10.1038/bjc.2011.196
Anttila A, Pukkala E, Söderman B, Kallio M, Nieminen P, Hakama M (1999) Effect of organised screening on cervical cancer incidence and mortality in Finland, 1963–1995: recent increase in cervical cancer incidence. Int J Cancer 83:59–65
Mathew A, George PS (2009) Trends in incidence and mortality rates of squamous cell carcinoma and adenocarcinoma of cervix—worldwide. Asian Pac J Cancer Prev 10:645–650
Mosavi-Jarrahi A, Kliewer EV (2013) Cervical cancer incidence trends in Canada: a 30-year population-based analysis. J Obstet Gynaecol Can 35:620–626
Cheung FY, Mang OW, Law SC (2011) A population-based analysis of incidence, mortality, and stage-specific survival of cervical cancer patients in Hong Kong: 1997–2006. Hong Kong Med J 17:89–95
Cecchini S, Ciatto S, Zappa M, Biggeri A (1995) Trends in the prevalence of cervical intraepithelial neoplasia grade 3 in the district of Florence, Italy. Tumori 81:330–333
de Almeida FM, de Oliveira JC, Martins E, Curado MP, de Freitas R Jr, Moreira MA (2013) Monitoring the profile of cervical cancer in a developing city. BMC Public Health 13:563. doi:10.1186/1471-2458-13-563
de Sanjose S, Quint WG, Alemany L, Geraets DT, Klaustermeier JE, Lloveras B, Tous S, Felix A, Bravo LE, Shin HR, Vallejos CS, de Ruiz PA, Lima MA, Guimera N, Clavero O, Alejo M, Llombart-Bosch A, Cheng-Yang C, Tatti SA, Kasamatsu E, Iljazovic E, Odida M, Prado R, Seoud M, Grce M, Usubutun A, Jain A, Suarez GA, Lombardi LE, Banjo A, Menéndez C, Domingo EJ, Velasco J, Nessa A, Chichareon SC, Qiao YL, Lerma E, Garland SM, Sasagawa T, Ferrera A, Hammouda D, Mariani L, Pelayo A, Steiner I, Oliva E, Meijer CJ, Al-Jassar WF, Cruz E, Wright TC, Puras A, Llave CL, Tzardi M, Agorastos T, Garcia-Barriola V, Clavel C, Ordi J, Andújar M, Castellsagué X, Sánchez GI, Nowakowski AM, Bornstein J, Muñoz N, Bosch FX; on behalf of the Retrospective International Survey and HPV Time Trends Study Group (2010) Human papillomavirus genotype attribution in invasive cervical cancer: a retrospective cross-sectional worldwide study. Lancet Oncol 11:1048–1056. doi:10.1016/S1470-2045(10)70230-8
Giuntoli LR, Bristow RE (2008) Cervical cancer, chapter 58. In: Gibbs RS, Karlan BY, Haney AF, Nygaard IE (eds). Danforth’s Obstetrics and Gynecology, 10th edn. Lippincott Williams and Wilkins, Philadelphia, pp 971–988
Menczer J, Kogan L, Schejter E, Liphshiz I, Barchana M (2011) A population-based study of selected demographic characteristics of Israeli-Jewish women with cervical squamous cell carcinoma. Arch Gynecol Obstet 283:329–333. doi:10.1007/s00404-010-1582-2
Kogan L, Menczer J, Shejter E, Liphshitz I, Barchana M (2011) Selected demographic characteristics of Israeli Jewish women with high-grade cervical intraepithelial neoplasia (CIN3): a population-based study. Arch Gynecol Obstet 283:329–333. doi:10.1007/s00404-010-1399-z
Arbyn M, Castellsagué X, de Sanjosé S, Bruni L, Saraiya M, Bray F, Ferlay J (2011) Worldwide burden of cervical cancer in 2008. Ann Oncol 22:2675–2686. doi:10.1093/annonc/mdr015
Menczer J, Barchana M, Chetrit A, Liphshitz I, Sadetzki S (2009) Incidence rates of cervical carcinoma among first- and second-generation women of North African origin in Israel. Int J Gynecol Cancer 19:1606–1609. doi:10.1111/IGC.0b013e3181a84035
Khan MJ, Partridge EE, Wang SS, Schiffman M (2005) Socioeconomic status and the risk of cervical intraepithelial neoplasia grade 3 among oncogenic human papillomavirus DNA-positive women with equivocal or mildly abnormal cytology. Cancer 104:61–70
Acknowledgments
We would like to give our sincerest thanks to the following people: Lia Supino Rosin, Michael Schvimer and Judith Sandbank from the Institute of Pathology, Central Lab, Maccabi Healthcare Services, Rehovot, Israel, for their laboratory work.
Conflict of interest
The authors declare that they have no conflict of interest.
Author information
Authors and Affiliations
Corresponding author
Additional information
This work was performed in partial fulfillment of the requirements for a Ph.D. degree of Ravit Bassal, Sackler Faculty of Medicine, Tel Aviv University, Israel.
Rights and permissions
About this article
Cite this article
Bassal, R., Schejter, E., Bachar, R. et al. Recent trends of cervical cancer and Cervical Intraepithelial Neoplasia 3 (CIN3) in Israel. Arch Gynecol Obstet 292, 405–413 (2015). https://doi.org/10.1007/s00404-015-3655-8
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00404-015-3655-8