S1383
Interdisciplinary - Health economics & health services research
ESTRO 2026
1 Radiation Oncology, University of Toronto, Toronto, Canada. 2 Obstetrics and Gynecology, University of Toronto, Toronto, Canada Purpose/Objective: Changes in cervical cancer incidence over time due to screening and vaccination programs can have long- term impacts on the need for radiation therapy resources.1 In Ontario, Canada, a publicly funded HPV vaccination program for 13-14 year-old girls was introduced in 2007. The long-term population-level impact of this vaccination program on cervical cancer incidence has not yet been investigated. This study evaluated the effect of Ontario’s HPV vaccination program on cervical cancer incidence from 2006 to 2020. Material/Methods: Age-adjusted incidence rates for invasive cervical neoplasms (squamous, adenosquamous, and adenocarcinoma) and high-grade intraepithelial neoplasms were obtained from the Ontario Cancer Registry.2 Individuals were stratified according to their age at diagnosis and rurality. Differences in incidence rates were examined with rate ratios. Changes in temporal trends were evaluated using Joinpoint Regression (version 5.4.0). A p-value threshold of 0.05 was used for statistical significance. Results:
increase in incidence rate from 26.2 to 35.7 per 100,000 person-years (rate ratio 1.36, p<0.01) and the overall average annual change was +3.1%/year (p=0.99). Conclusion: Cervical invasive and high-grade intraepithelial neoplasm incidence among Ontario women aged 20– 24 declined markedly following the HPV vaccination program, with no comparable reduction yet observed in older cohorts. Modest decline in cervical cancer screening rates from 66.2% in 2006 to 54.5% in 2020, should be considered alongside vaccination effects when interpreting these trends.3 Continued epidemiologic surveillance will be essential to inform workforce and educational planning within radiation oncology. References: 1. Atun R, Jaffray DA, Barton MB, Bray F, Baumann M, Vikram B, et al. Expanding global access to radiotherapy. The Lancet Oncology 2015;16:1153–86. https://doi.org/10.1016/S1470-2045(15)00222-3.2. Morphology & Grade n.d. https://training.seer.cancer.gov/cervical- uterine/cervix/abstract-code-stage/morphology.html (accessed November 11, 2025).3. Ontario Cancer Screening Performance Report, 2020 n.d. https://www.cancercareontario.ca/en/cancer-care- ontario/programs/screening-programs/screening- performance-report-2020 (accessed November 11, 2025). Keywords: HPV immunization, cervical neoplasia, incidence Sustainable Radiation Therapy: Evaluating Energy Consumption and Carbon Savings from Hypo- Fractionation Approaches at NCCS. Eric Pei Ping Pang 1,2 , Rachel Haixia Li 3 , James Yong Tatt Tan 4 , Yoshiaki Hirahata 5 , Yuki Imada 6 , Huishan Huang 1 , Hester Wei Xia Lee 1 , Fuh Yong Wong 1,3 1 Division of Radiation Oncology, National Cancer Centre Singapore, Singapore, Singapore. 2 Oncology Academic Clinical Programme, Duke-NUS Graduate Medical School, Singapore, Singapore. 3 Cancer Informatics, National Cancer Centre Singapore, Singapore, Singapore. 4 Operations Support Services, National Cancer Centre Singapore, Singapore, Singapore. 5 Therapy System Business, Healthcare Business Group, Hitachi High-Tech Corporation, Tokyo, Japan. 6 Industrial Products Business Unit, Hitachi Asia Ltd, Singapore, Singapore Purpose/Objective: This retrospective study quantifies the energy consumption and projects potential energy savings Digital Poster 717
Between 2006 and 2020, 94,932 cases of invasive and high-grade intraepithelial neoplasms were diagnosed. Among women aged 20–24, incidence declined from 92.1 to 27.8 per 100,000 person-years (rate ratio 0.30, p<0.01) during this time, representing a 69.8% reduction. Rates initially rose from 2006–2010 (+11.6%/yr), then declined significantly from 2010– 2018 ( − 8.3%/yr) and 2018–2020 ( − 33.8%/yr), with an overall average annual change of − 7.4%/yr (p=0.002) from 2006 to 2020. Downward trends were consistent across geography in this age group. Urban populations had an average annual change of -7.0%/yr (p=0.03) and rural populations had an average annual change of -8.1%/yr (p=0.059). In women aged 25-34, there was a modest decline in incidence rate from 120.4 to 110.0 per 100,000 person-years (rate ratio 0.91, p=0.003) and an overall average annual change of -0.1%/year (p=0.94). In women aged >34 years, there was an
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