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Total burden and incidence of in situ and invasive cervical carcinoma in Michigan, 1985–2003†‡

  1. Glenn Copeland MBA1,§,*,
  2. S. Deblina Datta MD2,
  3. Georgia Spivak BS1,
  4. Ann Davis Garvin MS, CNM3,
  5. Michele L. Cote PhD4

Article first published online: 3 NOV 2008

DOI: 10.1002/cncr.23747

Issue

Cancer

Cancer

Supplement: Assessing the Burden of HPV-Associated Cancers in the United States

Volume 113, Issue Supplement 10, pages 2946–2954, 15 November 2008

Additional Information

How to Cite

Copeland, G., Datta, S. D., Spivak, G., Garvin, A. D. and Cote, M. L. (2008), Total burden and incidence of in situ and invasive cervical carcinoma in Michigan, 1985–2003. Cancer, 113: 2946–2954. doi: 10.1002/cncr.23747

Author Information

  1. 1

    Michigan Cancer Surveillance Program, Michigan Department of Community Health, Lansing, Michigan

  2. 2

    Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia

  3. 3

    Cancer Control Section, Michigan Department of Community Health, Lansing, Michigan

  4. 4

    Population Studies and Prevention, Karmanos Cancer Institute and Wayne State University School of Medicine, Detroit, Michigan

  1. §

    Fax: (517) 335-9711.

*Michigan Cancer Surveillance Program, Michigan Department of Community Health, 201 Townsend, PO Box 30691, Lansing, MI 48913

  1. †

    This article is a US Government work and, as such, is in the public domain in the United States of America.

  2. ‡

    The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention.

Publication History

  1. Issue published online: 3 NOV 2008
  2. Article first published online: 3 NOV 2008
  3. Manuscript Accepted: 6 JUN 2008
  4. Manuscript Revised: 2 JUN 2008
  5. Manuscript Received: 14 APR 2008

Funded by

  • Centers for Disease Control
  • National Cancer Institute
  • Michigan Department of Community Health
  • Cooperative Agreement. Grant Number: U50 DP424071-04
  • Centers for Disease Control and Prevention (CDC)

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Keywords:

  • cervical carcinoma;
  • in situ cervical carcinoma;
  • State of Michigan;
  • human papillomavirus

Abstract

BACKGROUND.

With the recent licensure of a vaccine that protects against human papillomavirus (HPV) types 16 and 18, US women are expected to experience lower rates of cervical cancer. However, surveillance systems must be in place in the US to measure the real-world effectiveness of vaccination programs. Although population-based registries will provide invasive cervical cancer (ICC) incidence and burden data, the impact of HPV vaccine on cervical cancer will not be measurable for several decades. Cervical carcinoma in situ (CIS), a cervical precancer and the immediate precursor to ICC, is an earlier presentation of HPV-related cervical disease that affects a much larger number of women, and monitoring trends in CIS could provide an earlier measure of HPV vaccine effectiveness. Currently, registries do not collect data on CIS except for the state cancer registry in Michigan, which has been continually collecting CIS data since 1985.

METHODS.

All cases of CIS and ICC diagnosed from 1985 through 2003 in the Michigan registry were identified. Available data include age at diagnosis, race, morphologic tumor type, and tumor behavior.

RESULTS.

There were 58,144 cases of CIS and ICC, of which 48,272 (83.0%) were CIS and 9872 (17.0%) were ICC. There were 2928 CIS cases and 413 ICC cases diagnosed in Michigan during 2003, compared with 1577 CIS and 516 ICC cases reported in 1985. Age-adjusted CIS rates increased from 1985 (31.7 per 100,000) to 2003 (59.2 per 100,000); rates of CIS were highest among women age <40 years. Age-adjusted rates of ICC have declined since 1990, when the rate was 14 per 100,000 females; the rate is currently down to 7.8 per 100,000 females in 2003.

CONCLUSIONS.

The rising rates of CIS in women age <40 years, coupled with declining rates of ICC, suggests the important role of early CIS detection in the prevention of ICC. The CIS trend data, used in conjunction with ICC trend data, help to provide a more thorough picture of cervical disease in the state and also provide baseline data regarding CIS burden in a prevaccine era. The experiences of the Michigan registry can inform the development of CIS surveillance in other registries, an important potential registry role relative to monitoring cervical cancer prevention efforts. Cancer 2008;113(10 suppl):2946–54. Published 2008 by the American Cancer Society.

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