{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T16:47:53Z","timestamp":1791823673082,"version":"4.3.4"},"reference-count":29,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","license":[{"start":{"date-parts":[[2019,11,1]],"date-time":"2019-11-01T00:00:00Z","timestamp":1572566400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2019,11]]},"abstract":"<jats:p>Cervical cancer (CC) control is based on the implementation of effective screening programs. In the coming years, human papilloma virus vaccination coverage will contribute considerably toward cancer prevention. In Italy, where an organized screening program has been implemented, immigration from low\/middle-income countries with a high prevalence of human papilloma virus infections has increased steadily over the last decades. To assess the impact of screening efforts in counteracting background changes, we analyzed the incidence trends of cervical intraepithelial neoplasia grade 3 carcinomas <jats:italic toggle=\"yes\">in situ<\/jats:italic> (CIS) and invasive CC from 1994 to 2013 through an Age\u2013Period\u2013Cohort model using data of a regional population-based registry. Moreover, using Joinpoint regression, we compared the incidence of cervical lesions in native women with that observed in foreign-born women, highlighting the differences in age and screening status. The results indicate that the CC incidence trend decreased in Italian women (annual percent change = \u22122.7*%, 95% confidence interval = \u22124.3; \u22121.1), but increased (APC = 12.2*%, 95% confidence interval = 7.6; 17.0) in immigrants. For CIS, incidence rates show a growing trend in both groups, especially in women born abroad. For cancer, no marked changes in period-specific incidence rate ratios were detected until around 2000, when we found a slight decrease, followed by an increase. For CIS, we estimate an important upward trend in cohort-specific risks. The favorable effect of screening in preventing an increase in CC incidence has been counteracted by the progressive increase in immigrants from high-risk countries, where it is of increasing relevance to extend the use of vaccination.<\/jats:p>","DOI":"10.1097\/cej.0000000000000495","type":"journal-article","created":{"date-parts":[[2018,11,13]],"date-time":"2018-11-13T23:34:31Z","timestamp":1542152071000},"page":"529-536","source":"Crossref","is-referenced-by-count":10,"title":["Immigration, screening, and cervical cancer incidence: an application of Age\u2013Period\u2013Cohort analysis"],"prefix":"10.1097","volume":"28","author":[{"given":"Dania","family":"Bucchi","sequence":"first","affiliation":[{"name":"School of Specialization in Hygiene and Preventive Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manuela","family":"Chiavarini","sequence":"additional","affiliation":[{"name":"Department of Experimental Medicine, Public Health Section, University of Perugia, Perugia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fortunato","family":"Bianconi","sequence":"additional","affiliation":[{"name":"Umbria Cancer Registry, Umbria, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria E.","family":"Galeotti","sequence":"additional","affiliation":[{"name":"School of Specialization in Hygiene and Preventive Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessio","family":"Gili","sequence":"additional","affiliation":[{"name":"Umbria Cancer Registry, Umbria, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabrizio","family":"Stracci","sequence":"additional","affiliation":[{"name":"School of Specialization in Hygiene and Preventive Medicine"},{"name":"Department of Experimental Medicine, Public Health Section, University of Perugia, Perugia"},{"name":"Umbria Cancer Registry, Umbria, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"R2-20230902","doi-asserted-by":"crossref","first-page":"999","DOI":"10.1007\/s10552-016-0777-7","article-title":"Inequalities in cancer incidence and mortality across medium to highly developed countries in the twenty-first century.","volume":"27","author":"Arnold","year":"2016","journal-title":"Cancer Causes Control"},{"key":"R3-20230902","doi-asserted-by":"crossref","first-page":"937","DOI":"10.1002\/ijc.26084","article-title":"Cervical screening participation and risk among Swedish-born and immigrant women in Sweden.","volume":"130","author":"Azerkan","year":"2012","journal-title":"Int J Cancer"},{"key":"R4-20230902","doi-asserted-by":"crossref","first-page":"1105","DOI":"10.1007\/s10552-015-0603-7","article-title":"Trends in the incidence of cervical cancer and severe precancerous lesions in Denmark, 1997\u20132012","volume":"26","author":"Baldur-Felskov","year":"2015","journal-title":"Cancer Causes Control"},{"issue":"Suppl 7","key":"R5-20230902","doi-asserted-by":"crossref","first-page":"H32","DOI":"10.1016\/j.vaccine.2013.02.071","article-title":"Patterns and trends in human papillomavirus-related diseases in Central and Eastern Europe and Central Asia.","volume":"31","author":"Bray","year":"2013","journal-title":"Vaccine"},{"key":"R6-20230902","doi-asserted-by":"crossref","first-page":"1789","DOI":"10.1086\/657321","article-title":"Cervical human papillomavirus prevalence in 5 continents: meta-analysis of 1 million women with normal cytological findings.","volume":"202","author":"Bruni","year":"2010","journal-title":"J Infect Dis"},{"key":"R7-20230902","doi-asserted-by":"crossref","first-page":"321","DOI":"10.1097\/CEJ.0000000000000173","article-title":"Cervical cancer screening in immigrant women in Italy: a survey on participation, cytology and histology results.","volume":"25","author":"Campari","year":"2016","journal-title":"Eur J Cancer Prev"},{"key":"R8-20230902","doi-asserted-by":"crossref","first-page":"469","DOI":"10.1002\/sim.4780060406","article-title":"Models for temporal variation in cancer rates. 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