Four loci including DAPK, MGMT, p16 and PTEN were selected for methylation analysis in 127 cervical cancers; APC, CDH13, p16 and hMLH1 were examined in 60 endometrial cancers; and BRCA1, p14, p16 and PTEN in 49 ovarian cancers.
The frequencies of occurrence of hypermethylation in 4 candidate genes in individual samples of each cancer type (DAPK, MGMT, p16 and PTEN in 127 cervical cancers; APC, CDH13, hMLH1 and p16 in 60 endometrial cancers; and BRCA1, p14, p16 and PTEN in 49 ovarian cancers) were examined for further confirmation.
Cervical carcinoma incidence (APC = −2.7%) also decreased significantly.
We used joinpoint regression to assess annual percent changes (APC) in cervical cancer incidence and mortality before and after the introduction of organised cervical screening in 1991.
We used generalised linear models, assuming a Poisson distribution and a log link function, to compare the annual percent change (APC) in cervical cancer incidence and mortality rates from 1973 to 1991 and from 1991 to 2008.
There was a highly significant difference in the annual percent changes (APC) in cervical cancer incidence and mortality when rates before 1991 were compared with those after the introduction of organised screening in 1991 in NSW women of all ages and countries of birth.
The overall trends in incidence up to and after 1991 were also evident in the APCs in incidence for the broad age categories 20 49 years, 50 69 years and 70+ years (p≤0.002 in each case; Figures 1b-d and Table 2) and in the APC in cervical cancer mortality for women aged <49 years (p<0.0001; Figure 1d).
Cervical cancer mortality projections based on APC trends presented herewith suggest that the introduction of effective population screening could potentially prevent a continuing epidemic that would have culminated in about 4000 cancer deaths and 30 000 years of life by 2016, incremental to the current status quo of haphazard screening.
Mortality from ovarian cancer (APC = −2.6%) and cervical cancer (APC = −6.8%) cancer decreased significantly.
