Trends in incidence of and mortality from invasive cancer of the uterine cervix in Scotland (1975-1994)

Objective: I. To identify major trends in the incidence of and mortality fr om invasive cancer of the cervix uteri in Scotland during the twenty year p eriod 1975-1994; II. to consider the extent to which these trends may have been shaped by the introduction of systematic cervical screening. Design: Analysis of annual age standardised and age specific rates for inci dence and mortality, based on data collected by the Scottish Cancer Registr y and the General Register Office for Scotland. Setting: Scotland. Subjects: Women registered with the Scottish Cancer Registry as having deve loped invasive cancer of the cervix during the period of interest. Results: Annual all ages incidence rates of invasive cervical cancer show l ittle overall change over the period 1975-1989, but exhibit a pronounced de cline from 1990 onwards. All-ages mortality rates show clear evidence of de cline during the period 1975-1994, the rate for 1994 being some 30% lower t han that for 1975. Annual age-specific incidence rates show different patte rns by age group, with clear evidence of decreasing trends in the age range 50-64 years but different patterns in younger and older age groups. Most a ge groups show steep declines in incidence from 1990 onwards. Age specific mortality rates for 1975-1994 exhibit the most pronounced decreasing trends in the age range 50-64 years. The trends identified are broadly similar to those experienced in England and Wales over an approximately comparable pe riod. Conclusions: The overall (all ages) incidence of invasive cervical cancer i n Scotland changed little during the period 1975-1989, but declined sharply from 1990 onwards. The most pronounced decline in incidence across the per iod 1975-1994 appears to have taken place in the age range 50-64 years. Thi s decline has been accompanied by a commensurate fall in mortality in the s ame age range. These reductions in incidence and mortality may be attributa ble in part to increased coverage of cervical screening programmes during t he period of interest. Evidence from other studies suggest that, without th e increased coverage of cervical screening achieved during this period inci dence rates in Scotland might have been seen to increase.