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

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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.

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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.

Author information

Authors and Affiliations

  1. Virus, Lifestyle and Genes, Danish Cancer Society Research Center, 2100, Copenhagen, Denmark

    Birgitte Baldur-Felskov, Christian Munk, Thor Schütt Svane Nielsen & Susanne K. Kjaer

  2. Statistics, Bioinformatics and Registry, Danish Cancer Society Research Center, 2100, Copenhagen, Denmark

    Christian Dehlendorff

  3. Department of Gynecology and Obstetrics, Hvidovre University Hospital, 2650, Hvidovre, Denmark

    Benny Kirschner

  4. Department of Pathology, Hvidovre University Hospital, 2650, Hvidovre, Denmark

    Jette Junge

  5. Department of Gynecology, Rigshospitalet, Copenhagen University Hospital, 2100, Copenhagen, Denmark

    Susanne K. Kjaer

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  1. Birgitte Baldur-Felskov
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  2. Christian Munk
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  3. Thor Schütt Svane Nielsen
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  4. Christian Dehlendorff
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Corresponding author

Correspondence to Susanne K. Kjaer.

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The sponsor of the study had no role in the study design, data collection, data analysis, data interpretation, or writing the report. The corresponding author had full access to all the data and had final responsibility for the decision to submit for publication.

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Baldur-Felskov, B., Munk, C., Nielsen, T.S.S. et al. Trends in the incidence of cervical cancer and severe precancerous lesions in Denmark, 1997–2012. Cancer Causes Control 26, 1105–1116 (2015). https://doi.org/10.1007/s10552-015-0603-7

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  • DOI: https://doi.org/10.1007/s10552-015-0603-7

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