Search

Although local treatments for cervical intraepithelial neoplasia (CIN) are highly effective, it has been reported that treated women remain at increased risk of cervical and other cancers. Our aim is to explore the risk of developing or dying from cervical cancer and other human papillomavirus (HPV)- and non-HPV-related malignancies after CIN treatment and infer its magnitude compared with the general population. Design: Systematic review and meta-analysis. Eligibility criteria: Studies with registry-based follow-up reporting cancer incidence or mortality after CIN treatment. Data synthesis: Summary effects were estimated using random-effects models. Incidence rate of cervical cancer among women treated for CIN (per 100 000 woman-years). Relative risk (RR) of cervical cancer, other HPV-related anogenital tract cancer (vagina, vulva, anus), any cancer, and mortality, for women treated for CIN versus the general population. Twenty-seven studies were eligible. The incidence rate for cervical cancer after CIN treatment was 39 per 100 000 woman-years (95% confidence interval 22–69). The RR of cervical cancer was elevated compared with the general population (3.30, 2.57–4.24; P < 0.001). The RR was higher for women more than 50 years old and remained elevated for at least 20 years after treatment. The RR of vaginal (10.84, 5.58–21.10; P < 0.001), vulvar (3.34, 2.39–4.67; P < 0.001), and anal cancer (5.11, 2.73–9.55; P < 0.001) was also higher. Mortality from cervical/vaginal cancer was elevated, but our estimate was more uncertain (RR 5.04, 0.69–36.94; P = 0.073). Women treated for CIN have a considerably higher risk to be later diagnosed with cervical and other HPV-related cancers compared with the general population. The higher risk of cervical cancer lasts for at least 20 years after treatment and is higher for women more than 50 years of age. Prolonged follow-up beyond the last screening round may be warranted for previously treated women. • Women previously treated for CIN are at elevated risk of cervical and other HPV-related neoplasms. • Risk of cervical cancer remains elevated for at least 20 years after treatment. • Prolonged cervical screening beyond current last screening round at 60 or 65 should be considered. • Increased awareness for prevention or early cancer detection of other HPV-related malignancies is needed. [ABSTRACT FROM AUTHOR]

Abstract This study investigates the urban-rural and sex differences in the increased risks of the ten most common cancers in China related to high PM 2.5 concentration in the southeastern side of Hu line. Pearson correlation coefficient is estimated to reveal how the cancers closely associated with PM 2.5 long-term exposure. Then linear regression is conducted to evaluate sex- and area-specific increased risks of those cancers from high level PM 2.5 long-term exposure. The major finding is with the increase of every 10 μg/m3 of annual mean PM 2.5 concentration, the increase of relative risks for lung cancer incidence and mortality are 15% and 23% for males, and 22% and 24% for females in rural area. For urban area, the increase of relative risk for ovarian cancer incidence is 9% for females, while that for prostatic cancer increases 17% for males. For leukemia, the increase of relative risks for incidence and mortality are 22% and 19% for females in rural area, while in urban area the increase of relative risk for mortality is 9% for males and for incidence is 6% for females. It is also found that with increased PM 2.5 exposure, the risks for ovarian and prostatic cancer rise significantly in urban area, while risks for lung cancer and leukemia rise significantly in rural area. The results demonstrate the higher risks for lung cancer and leukemia with increased PM 2.5 exposure are more significant for female. This study also suggests that the carcinogenic effects of PM 2.5 have obvious sex and urban-rural differences. Highlights • Increased risks for lung, ovarian, prostate cancers and leukemia are closely associated with increased PM 2.5 exposure (Short version: Lung/ovarian/prostate cancer and leukemia are closely related with increased PM 2.5). • PM 2.5 significantly impacts the risks for lung cancer and leukemia in rural area. • PM 2.5 significantly impacts the risks for prostate and ovarian cancers in urban area. • Females are at higher risks for lung cancer and leukemia due to elevated PM 2.5 [ABSTRACT FROM AUTHOR]