FC 03-07TEN YEARS STUDY OF INVASIVE CERVICAL CANCER: MICROINVASIVES CASES INCREASE IN CO-TESTING PERIOD

22. Cervical neoplasia
R. Oncins 1, M.D. Comes 1, M.Á. Aragón 2, E. Clemente 3, V. Calderero 4, L. Guardia 5, V. Vallés 6.
1Hospital de Barbastro, Pathology Unit (Spain), 2Hospital de Barbastro, Gynaecology Service (Spain), 3Hospital de Barbastro, Preventive Medicine Unit (Spain), 4Hospital de Barbastro, Oncology Unit (Spain), 5Hospital de Barbastro, Gynaecology Unit (Spain), 6Hospital de Barbastro, Primary Care Direction (Spain)

Background / Objectives

To study the impact of Human Papillomavirus (HPV) screening plus cytology (co-testing) in the detection of invasive cervical carcinomas in a low incidence area in the north of Spain, adapting the Spanish Society of Gynaecology and Obstetrics (SEGO) scientific protocols.

 

 

 


Methods

Area served by Hospital of Barbastro: A target population of 27,490 women between 25 to 65 years. Period of time: From January 1st 2006 to December 31st 2010 (G1) screening was performed with cytology and from January 1st 2011 to December 31st 2015 (G2) the screening was with cytology and HPV test. The detection of HPV has been through Hybrid Capture (HC2) until the end of 2011 and PCR hrHPV-DNA with Cobas 4800® later. The follow up was until April 30th 2017. The patients came from Primary Care (PC) screening and from gynaecology service screened according to SEGO 2006 protocol (only cytology) for G1 and to 2010 protocol (co-testing) for G2. Demographic, pathological and clinical characteristics were studied.


Results

A total of 30 invasive cases were detected. In G1, 22,888 cytologies (69.6% in PC) and 1,877 HPV tests (43.0% in PC) were performed. The mean age was 45.9 years. 12 (40%) invasive cases were detected in this group. 4 patients (33.3%) died with a survival average of 37.9 months. In G2, 22,740 cytologies were performed (83.5% coming from PC) and 17,209 HPV tests (80.5% in PC). The mean age was 48.6 years. 18 invasive cases were detected, 4 patients died (22.2%) and the survival average was 7.6 months. In G1 the histological type was squamous carcinoma in all except 1 neuroendocrine carcinoma. 3 (25%) cases were A1 stage. In G2, 7adenocarcinomas and 11 squamous carcinomas were diagnosed. 6 (33.3%) cases were A1 stage.


Conclusion

In G2 period more microinvasive cases  and adenocarcinomas  were detected. This increase is related mainly to screening based in Primary Care and co-testing. Mortality has not changed despite the detection of a higher number of cases due to early stages at the moment of diagnosis. 5 years are not enough to know the impact of early detection in mortality.  


References