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Evidence for cervical cancer mortality with screening program in Taiwan, 1981–2010 age-period-cohort model.doc

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Evidence for cervical cancer mortality with screening program in Taiwan, 1981–2010 age-period-cohort model

Suetal.BMCPublicHealth2013,13:13 /1471-2458/13/13 RESEARCH ARTICLE OpenAccess Evidenceforcervicalcancermortalitywith screeningprograminTaiwan,1981–2010: age-period-cohortmodel Shih-YungSu1,2,Jing-YangHuang1,Chien-ChangHo3andYung-PoLiaw1* Abstract Background:Cervicalcanceristhemostcommoncancerexperiencedbywomenworldwide;however,screening techniquesareveryeffectiveforreducingtheriskofdeath.Thenationalcervicalcancerscreeningprogramwas implementedinTaiwanin1995.Theobjectiveofthisstudywastoexamineandprovideevidenceofthecervical cancermortalitytrendsfortheperiodsbeforeandafterthescreeningprogramwasimplemented. Methods:Datafrom1981to2010ofthecausesofdeathregisteredwereobtainedfromtheDepartmentofHealth, Taiwan.Age-standardizedmortalityrates,age-specificrates,andage-period-cohortmodelsthatemployedthe sequentialmethodwereusedtoassesstemporalchangesthatoccurredbetween1981and2010,with1995used astheseparatingyear. Results:Theresultsshowedthatforbothtimeperiodsof1981to1995and1996to2010,ageandperiodhad significanteffects,whereasthebirthcohorteffectswereinsignificant.Forpatientsbetween80and84yearsofage, themortalityratefor1981to1995and1996to2010was48.34and68.08.Thecervicalcancermortalityratefor 1996to2010was1.0forpatientsbetween75and79yearsofageand1.4forpatientsbetween80and84yearsof agecomparedtothatfor1981to1995.Regardingtheperiodeffect,themortalitytrenddecreased2-foldfrom1996 to2010. Conclusions:Theresultsofthisstudyindicateadeclineincervicalcancermortalitytrendsafterthescreening programinvolvingPapanicolaoutestswasimplementedin1995.However,thepositiveeffectsofthescreening programwerenotobservedinelderlywomenbecauseoftreatmentdelaysduringtheinitialimplementationofthe screeningprogram. Keywords:Cervicalcancer,Age-period-cohortmodel,Mortality,Gynecologiconcology,Screeningprogram Background countries [1,2]. National cervical cancer screening pro- Cervical cancer is the most common and serious gyne- gramshavebeenimplementedinmanycountriesthrough- cologic malignancy worldwide. Thi