An overview of cervical cancer

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An overview of cervical cancer Naomi Brewer University of Otago, Wellington, Department of Public Health The control of cervical cancer in New Zealand: Achievements and future prospects Auckland, 5 August
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An overview of cervical cancer Naomi Brewer University of Otago, Wellington, Department of Public Health The control of cervical cancer in New Zealand: Achievements and future prospects Auckland, 5 August 2016 Burden of Disease Epidemiology, Equity and Cost-Effectiveness Programme (BODE³) The cause of cervical cancer Virtually all cervical cancers result from a persistent infection with certain high-risk types of human papillomavirus (HPV) 12 types of HPV now consistently classified as high-risk 8 other types of HPV considered likely to be high-risk HPV infections very common lifetime risk ~80% But, cervical cancer is a rare complication Most infections clear without causing abnormalities Sources: Steenbergen RDM, et al. Clinical implications of (epi)genetic changes in HPV-induced cervical precancerous lesions. Nat Rev Cancer 2014; 14: Walboomers JM, et al. Human papillomavirus is a necessary cause of invasive cervical cancer worldwide. J Pathol 1999; 189: Baseman JG & Koutsky LA. The epidemiology of human papillomavirus infections. J Clin Virol 2005; 32 (Suppl 1): S16-S24. Cervical cancer around the world In 2012, worldwide: Estimated 528,000 new cases of cervical cancer Cervical cancer was fourth most common cancer in women Seventh most common cancer overall In 2012, worldwide: 266,000 deaths due to cervical cancer 7.5% of all female cancer deaths Source: Cancer Today, IARC (http://gco.iarc.fr/today/fact-sheets-cancers?cancer=16&type=0&sex=2). Estimated age-standardized rates (World) of incidence cases, females, cervical cancer, worldwide in 2012 Malawi All rights reserved. The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization / International Agency for Research on Cancer concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its Data source: GLOBOCAN 2012 frontiers or boundaries. Dotted and dashed lines on maps represent approximate borderlines for Graph production: Cancer Today which there may not yet be full agreement. (http://gco.iarc.fr/today) International Agency for Research on Cancer 2016 World Health Organization Estimated age-standardized rates (World) of deaths, females, cervical cancer, worldwide in 2012 Malawi All rights reserved. The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization / International Agency for Research on Cancer concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its Data source: GLOBOCAN 2012 frontiers or boundaries. Dotted and dashed lines on maps represent approximate borderlines for Graph production: Cancer Today which there may not yet be full agreement. (http://gco.iarc.fr/today) International Agency for Research on Cancer 2016 World Health Organization Cervical cancer in New Zealand In 2012: Cervical cancer 11 th most common cancer in women 21 st most common cancer overall 19 th most common cause of cancer death in women 23 rd most common cause of cancer death overall Source: Ministry of Health. Cancer: New registrations and deaths Wellington: Ministry of Health Cervical cancer in New Zealand continued In 2014: 142 new cases of cervical cancer Age-standardised incidence rate: 4.6 per 100,000 non-māori women 11.5 per 100,000 Māori women In 2013: 54 deaths from cervical cancer Age-standardised mortality rate: 1.4 per 100,000 non-māori women 4.0 per 100,000 Māori women Sources: Ministry of Health. Selected cancers 2012, 2013, Wellington: Ministry of Health Ministry of Health. Mortality 2013: Online tables (provisional). Wellington: Ministry of Health Historical summary Five-year moving average. Age-standardised to WHO world standard population. Source: Figure prepared by author using data provided by the Ministry of Health. Incidence by ethnicity Five-year moving average. Age-standardised to WHO world standard population. Source: Figure prepared by author using data provided by the Ministry of Health. Mortality by ethnicity Five-year moving average. Age-standardised to WHO world standard population. Source: Figure prepared by author using data provided by the Ministry of Health. Some possible explanations Screening history Stage at diagnosis Comorbid conditions Treatment Source: Epidemiological studies of cervical cancer survival in New Zealand: a thesis presented in partial fulfilment of the requirements for the degree of Doctor of Philosophy in Epidemiology at Massey University, Wellington Campus, New Zealand. Brewer, Naomi. 2011 Prevention Immunisation the HPV vaccine (Gardasil used in NZ) Smear test (cytology screening) cytology with high-risk HPV triage in women 30 years to help assess risk of progression HPV with cytology triage self-sampling for HPV testing Conclusion Cervical cancer is gradually becoming less common & fewer women dying from cervical cancer in NZ But, the decreases are not evenly distributed across the population Effective methods for the prevention of cervical cancer now exist and work is continuing to improve these methods Thank you!
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