Cancer Causes & Control

, Volume 26, Issue 8, pp 1105–1116 | Cite as

Trends in the incidence of cervical cancer and severe precancerous lesions in Denmark, 1997–2012

  • Birgitte Baldur-Felskov
  • Christian Munk
  • Thor Schütt Svane Nielsen
  • Christian Dehlendorff
  • Benny Kirschner
  • Jette Junge
  • Susanne K. Kjaer
Original paper
First Online:
Received:
Accepted:

Abstract

Purpose

The incidence of cervical cancer, including squamous cell carcinoma (SCC), has been decreasing in several developed countries since the onset of organized screening programs; in some countries, however, the incidence of adenocarcinoma has increased among young women. We investigated the Danish incidence trends during 1997–2011 when cervical screening coverage was high. Incidences of cervical intraepithelial neoplasia grade 3 (CIN3) and adenocarcinoma in situ (AIS) were also assessed, with the latest part of the study period coinciding with introduction of free-of-charge human papillomavirus (HPV) vaccination.

Methods

Using nationwide registries, we estimated age-specific and age-standardized incidence rates and estimated annual percentage change (EAPC).

Results

The incidence of SCC decreased significantly, especially in women aged ≥45 years [EAPC: −3.1 % (95 % CI −4.3 to −2.5)], whereas the incidence of adenocarcinoma increased significantly, from 2.4 to 3.1/100,000 primarily due to increases in women aged ≤44 years [EAPC: 4.3 % (95 % CI 1.8–6.7)]. The incidences of CIN3 and AIS increased significantly from 94.7 to 156.5/100,000 and 3.3 to 11.3/100,000, respectively, but, importantly, they decreased significantly during 2009–2012 in women aged ≤20 years.

Conclusions

The Danish screening program has successfully reduced the incidence of cervical cancer, especially of SCC in older women; however, the program has not significantly reduced the incidence in young women or the incidence of adenocarcinoma, which is increasing. Decreases in the incidences of CIN3 and AIS in age groups with high HPV vaccine coverage may herald a future decrease in cervical cancer incidence in young Danish women.

Keywords

Cervical cancer Adenocarcinoma in situ CIN3 HPV Vaccination Incidence 
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Notes

Acknowledgments

The study was supported by the Mermaid project (MERMAID II).

Conflict of interest

Birgitte Baldur-Felskov and Christian Munk received travel and speaker’s fees from Sanofi Pasteur MSD. Benny Kirchner has been on the advisory board and received travel fees from GlaxoSmithKline. Jette Junge received advisory board fees from Sanofi Pasteur MSD and consultant fees from Merck. Susanne K. Kjaer received advisory board, speaker’s fees and unrestricted research grants through her institution from Sanofi Pasteur MSD and Merck. Thor Schütt Svane Nielsen, and Christian Dehlendorff report no potential conflicts of interest.

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Copyright information

© Springer International Publishing Switzerland 2015

Authors and Affiliations

  • Birgitte Baldur-Felskov
    • 1
  • Christian Munk
    • 1
  • Thor Schütt Svane Nielsen
    • 1
  • Christian Dehlendorff
    • 2
  • Benny Kirschner
    • 3
  • Jette Junge
    • 4
  • Susanne K. Kjaer
    • 1
    • 5
  1. 1.Virus, Lifestyle and Genes, Danish Cancer Society Research CenterCopenhagenDenmark
  2. 2.Statistics, Bioinformatics and RegistryDanish Cancer Society Research CenterCopenhagenDenmark
  3. 3.Department of Gynecology and ObstetricsHvidovre University HospitalHvidovreDenmark
  4. 4.Department of PathologyHvidovre University HospitalHvidovreDenmark
  5. 5.Department of Gynecology, RigshospitaletCopenhagen University HospitalCopenhagenDenmark

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