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      Cervical cancer epidemiology in foreign women in Northern Italy: role of human papillomavirus prevalence in country of origin.

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          Abstract

          This study compares the incidence and treatments of cervical neoplasia in foreigners from high migration countries and Italians in the Reggio Emilia province (Northern Italy) in 2002-2009. Standardized incidence ratios (SIRs) and 95% confidence intervals (95% CI) for cervical intraepithelial neoplasia grade 3 (CIN3) and cancer were calculated for foreigners versus Italian women; foreigners were also classified according to the prevalence of human papillomavirus (HPV) in their country of origin. The proportion of hysterectomies is presented as an indicator of inappropriate surgery in CIN3 and microinvasive cancers. A higher risk was observed in women from high human papillomavirus prevalence countries (HHPVC) both for cancer and for CIN3 (SIR=4.1, 95% CI=2.2-6.9; SIR=2.0, 95% CI 1.7-2.5, respectively), whereas in those from low human papillomavirus prevalence countries (LHPVC), no difference for cancer and a lower risk for CIN3 were observed (SIR=1.0, 95% CI 0.2-2.2; SIR=0.6, 95% CI 0.4-0.8, respectively). A lower CIN3/cancer ratio was found in women from HHPVC (2.6) and in women from LHPVC (3.6) than in Italians (7.4). The percentage of hysterectomies for CIN3 or microinvasive cancers was 3.4 in foreigners and 4.7 in Italians. A higher risk of cervical cancer was found in women from HHPVC compared with Italians and women from LHPVC, suggesting a role of HPV prevalence in the country of origin in the excess risk. The CIN3/cancer ratio was lower for both women from HHPVC and women from LHPVC, also suggesting a role of low screening uptake for cervical cancer incidence in immigrants.

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          Author and article information

          Journal
          Eur. J. Cancer Prev.
          European journal of cancer prevention : the official journal of the European Cancer Prevention Organisation (ECP)
          Ovid Technologies (Wolters Kluwer Health)
          1473-5709
          0959-8278
          May 2015
          : 24
          : 3
          Affiliations
          [1 ] aInter-institutional Epidemiology Unit bPlanning and Control Staff, AUSL Reggio Emilia cArcispedale Santa Maria Nuova dCervical Cancer Screening Center, Arcispedale Santa Maria Nuova, IRCCS, Reggio Emilia, Italy.
          Article
          10.1097/CEJ.0000000000000137
          25714783
          0e5c3ff3-d935-47da-baaa-3f70f0141298
          History

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