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La epidemia de cáncer cervical que el cribado ha evitado en el Reino Unido
Julian Peto1, Clare Gilham, Olivia Fletcher
1London School of Hygiene and Tropical Medicine, London, UK. julian.peto@lshtm.ac.uk
Lancet (London, England)
|July 21, 2004
Resumen
El programa nacional de cribado cervical del Reino Unido ha revertido un peligroso aumento en las muertes por cáncer cervical, salvando unas 100.000 vidas. La detección temprana reduce significativamente las tasas de mortalidad de por vida para las mujeres.
Área de la Ciencia:
- Oncología Oncología.
- Salud Pública La salud pública.
- Epidemiología La epidemiología.
Sus antecedentes:
- Análisis recientes cuestionan la rentabilidad del programa nacional de cribado cervical del Reino Unido.
- Existen preocupaciones con respecto al impacto financiero y psicosocial del programa frente a la reducción de la mortalidad.
Objetivo del estudio:
- Para estimar las tendencias de mortalidad por cáncer de cuello uterino sin el programa nacional de cribado.
- Evaluar el impacto del programa nacional de cribado cervical del Reino Unido en las tasas de mortalidad.
Principales métodos:
- Análisis de las tendencias de mortalidad por cáncer cervical en Inglaterra y Gales antes de 1988.
- Modelado de tendencias futuras de mortalidad en ausencia de la iniciativa nacional de cribado.
Principales resultados:
- La mortalidad por cáncer de cuello uterino en mujeres menores de 35 años se triplicó entre 1967 y 1987, con una alta incidencia a pesar del cribado oportunista.
- El programa nacional de cribado, iniciado en 1988, ha invertido con éxito esta tendencia al alza de la mortalidad.
- Se estima que 100.000 muertes prematuras podrían evitarse en mujeres nacidas entre 1951-1970.
Conclusiones:
- El cribado cervical ha evitado una posible epidemia, evitando aproximadamente 6.000 muertes al año.
- Se estima que la detección salva a 1 de cada 80 mujeres en cohortes de nacimiento específicas a un costo de ~ £ 36,000 por vida salvada.
- El inicio temprano del cribado cervical se asocia con tasas de mortalidad de por vida sustancialmente más bajas.
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