Trends in corpus uteri cancer mortality in member states of the European Union

ObjectivesThe burden of corpus uteri cancer varies in the European Union (EU). We analysed trends in corpus uteri cancer mortality in 26 EU member states from 1970 onward.MethodsPopulation numbers and number of uterine cancer deaths were extracted from the World Health Organisation mortality database. Corpus uteri cancer mortality rates were corrected for certification problems using different reallocation rules for deaths registered as uterine cancer not otherwise specified, or using mixed disease codes. Join point regression was used to study the annual percentage change of age-standardised corpus uteri cancer mortality rates. Changes in corpus uteri cancer mortality rates by calendar period and standardised cohort mortality ratios were also estimated.ResultsIn 2008, 12,903 women died from corpus uteri cancer in the EU. Corrected age-standardised corpus uteri cancer mortality rates have decreased significantly over the past decades in most member states, with exception of Malta and Bulgaria, where rates increased; Greece, where rates remained low but stable; and Sweden, where rates have been stable since 1970. Original member states showed a steeper decrease than newer member states. The standardised cohort mortality ratios indicated that corpus uteri cancer mortality does not decrease further, nor does it increase, among women born after 1940, although these birth cohorts may still be too young for corpus uteri cancer incidence to be fully evaluated.ConclusionOur corrected corpus uteri cancer mortality rates showed a decrease in most EU member states among women born before 1940.     

Trends in cancer incidence in female breast, cervix uteri, corpus uteri, and ovary in India.

Trends in breast, cervix uteri, corpus uteri and ovarian cancers in six population based cancer registries (Mumbai, Bangalore, Chennai, Delhi, Bhopal, and Barshi) were evaluated over a period of the last two decades. For studying trends we used a model that fits this data is the logarithm of Y=ABx which represents a Linear Regression model. This approach showed a decreasing trend for cancer of the cervix and increasing trends for cancers of breast, ovary and corpus uteri throughout the entire period of observation in most of the registries. The four cancers, breast, cervix, corpus uteri and ovary, constitute more than 50% of total cancers in women. As all these cancers are increasing, to understand their etiology in depth, analytic epidemiology studies should be planned in a near future on a priority basis.     

2015年江苏省子宫体癌流行现状及2006—2015年趋势分析

目的 估算江苏省子宫体癌2015年发病和死亡情况,分析其流行现状及2006—2015年发病和死亡变化趋势.方法 利用江苏省疾病预防控制中心收集并质控合格的35个肿瘤登记处的2015年资料抽取子宫体癌数据,计算子宫体癌分城乡、性别和年龄组的发病率和死亡率,并结合2015年全省户籍人口数据,估算全省子宫体癌的发病数和死亡数...     

A method to estimate mortality trends when death certificates are imprecisely coded: An application to cervical cancer in Italy

Systematic analysis of mortality trends of cervix and corpus uteri cancers is difficult in Italy, as in many other countries, because of the poor specification of uterine cancer subsites in official death statistics. The aim of this article is to propose a method for the analysis of uterine cancers mortality based on high quality incidence and prevalence data from population‐based cancer registries. The method assumes that the excess mortality of cancer patients, compared to death rates expected in the general population, is attributable to the specific cancer. The method is applied to estimate mortality trends for cancers of cervix, corpus and uterus as whole, during the period 1987–1999, in an area covered by 8 Italian cancer registries. Official mortality rates for the 2 subsites were about 60% lower than excess mortality rates, due to the very high proportion of deaths attributed to not specified subsite. Age adjusted cervical cancer excess mortality rates decreased from 3.7 to 2.7 × 100,000 women. Excess mortality for corpus uteri cancer remained approximately stable between 3 and 3.3 × 100,000 women in the period 1990–1999. The results support the efficacy of organized screening in reducing cervical cancer mortality. The same method can be used to assess mortality rates for every cancer entity identifiable in cancer registries data, not otherwise available from official death records. © 2008 Wiley‐Liss, Inc.     

Cervical cancer mortality is increasing in Spanish women younger than 50

Spanish women seem to have low cervical cancer mortality rates and some studies suggest the trend is stationary; however, this fact remains unclear because a great number of uterine cancer cases are classified as site unspecified. The main goal in this paper is to study mortality trends due to cancer of the cervix in young Spanish women. The percentage of uterus cancer deaths recorded as site unspecified has fallen from 90% in 1965 to 25% in 1995. Mortality by cervical cancer decreases in women aged 25-49 born before 1939-1948 and increases in women born later. This result is shown in each 5-year age group and seems independent from the percentage of unspecified site uterine cancer. In conclusion, Spanish women aged under 50 are suffering an increase in cervix uteri mortality rates; this rise can be related with behavioural changes occurring from 1970-1975 on.     

2009—2015年甘肃省肿瘤登记地区子宫体癌发病与死亡特征分析

目的 分析甘肃省肿瘤登记地区2009—2015年子宫体癌发病和死亡流行状况及变化趋势,为甘肃省子宫体癌的防治提供依据.方法 审核整理2009—2015年甘肃省肿瘤登记地区子宫体癌发病(死亡)率、构成比、中国人口标化率(中标率)和世界人口标化率(世标率)等,分析年龄别发病及死亡情况,并通过Joinpoint回归模型计算年...     

2000~2009年浙江省肿瘤登记地区子宫体癌发病与死亡分析

[目的]分析浙江省肿瘤登记地区2000～2009年子宫体癌的发病与死亡情况。[方法]数据来源于浙江省6个肿瘤登记处上报于浙江省肿瘤防治办公室的肿瘤发病和死亡资料．分别计算发病（死亡）例数、粗发病率（死亡率）、构成比、中标率、世标率、累积率、截缩率以及年度变化百分比等指标。[结果]2000—2009年浙江省6个肿瘤登记地区共计报告子宫体癌新发病例2347例,占女性癌症新发病例的3-35％。子宫体癌发病率为7．92／10万,中标率为4．64／10万,位居女性癌症发病顺位的第9位。子宫体癌发病率呈总体增长趋势,从2000年的5．13／10万增长到2009年的8．69／10万,年度变化百分比（APC）为6．40％（95％CI：3．78％～9．08％）。2000～2009年共报告子宫体癌死亡病例854例,占女性癌症死亡病例的2．56％。子宫体癌死亡率为2．88／10万,中标率为1．41／10万,居女性癌症死因顺位的第11位。子宫体癌死亡率呈现波动增长趋势,年度变化百分比为5．84％（95％CI：-2．70％～15．13％）。[结论]浙江省子宫体癌发病和死亡呈上升趋势,应加强肿瘤防治等措施．以期降低子宫体癌的发病水平。     

2015年中国子宫体癌发病与死亡分析

目的根据中国各省市登记处上报的2015年肿瘤登记数据,估算2015年中国子宫体癌发病与死亡情况。方法收集整理中国501个登记处上报的2015年肿瘤登记数据,对数据进行质量审核和评估,将符合标准的368个登记处数据纳入分析,按地区(城市、农村、东部、中部和西部)和年龄等因素分层,计算子宫体癌的发病率和死亡率,结合2015年全国人口数据估算全国子宫体癌发病和死亡数据。标化率分别采用2000年全国普查人口和Segi′s世界标准人口计算。结果2015年纳入分析的368个登记处覆盖309553499人口,占全国2015年年末人口的22.52%。估计全国子宫体癌新发病例数约6.89万,发病率为10.28/10万,中标率为6.86/10万,世标率为6.66/10万。城市地区发病率(11.35/10万)高于农村地区(8.90/10万),东部地区发病率(12.12/10万)高于中部地区(9.94/10万)和西部地区(8.25/10万)。估计2015年全国因子宫体癌死亡病例数约1.60万,死亡率为2.39/10万,中标率为1.49/10万,世标率为1.47/10万。城市地区死亡率(2.40/10万)与农村地区(2.39/10万)相似;中部地区死亡率(2.55/10万)高于东部地区(2.32/10万)和西部地区(2.31/10万)。结论中国子宫体癌发病不断上升且有年轻化趋势,威胁女性健康,疾病负担逐渐加重。中国子宫体癌发病存在城乡和区域差异,应有针对性地开展防控工作。     

Trends in cervical cancer mortality in Korea 1993-2002: corrected mortality using national death certification data and national cancer incidence data

Cervical cancer is a major health problem for Korean women, accounting for 9.8% of new female cancer cases, even though incidence rates have been decreasing. The Korean cervical cancer mortality rate for 1993-2002 based on National Statistical Office data shows an increasing trend, but the actual rates are thought to have decreased by epidemiologists, clinicians and other cancer experts. To explain this gap and solve this problem, we corrected the number of cervical cancer deaths by comparing death certificate cases of unspecified uterine cancer data with the national cancer incidence databases of entire cancer registries in Korea. We used 2 different methods to make a correction. First, we considered "uterus, unspecified" deaths previously registered as "cervix, uterine" cases misclassified and added them to the cervical cancer deaths. Alternatively, we multiplied the total number of registered unspecified uterine cancer deaths by age-specific proportions of registered incident cervical cancer cases among all cancers and added the product to cervical cancer deaths. The overall corrected age-standardized cervical cancer mortality rates per 100,000 women decreased from 5.2 in 1993 to 3.9 in 2002 (estimated annual percentage change (EAPC): -4.05%, 95% CI: -4.88, -3.22). While cervical cancer mortality showed a decreasing tendency in women aged 30-69 years, it increased substantially in women aged > or =70 years (EAPC: 3.62%, 95% CI: 1.92-5.35). Results of this study will provide evidence-based foundation for the evaluation of the existing cervical cancer-screening programs.     

Geographic and temporal variations in cancer of the corpus uteri: incidence and mortality in pre- and postmenopausal women in Europe

Corpus uteri cancer is the fourth most common neoplasm in women in Europe and the tenth most common cause of cancer death. We examined geographic and temporal variations in corpus uteri cancer incidence and mortality rates in the age groups 25-49 and 50-74 in 22 European countries. The disease is considerably less common in premenopausal women, with incidence and mortality rates decreasing throughout Europe and mortality declines more marked in western and southern European countries. Incidence rates among postmenopausal women are highest in the Czech Republic, Slovakia, Sweden and Slovenia and lowest in France and the United Kingdom. Increasing incidence trends in this age group are observed in the Nordic countries (except Denmark) and in the United Kingdom. Some increases are also seen in eastern (Slovakia) and southern Europe (Spain and Slovenia), while relatively stable or modestly decreasing trends are observed in Italy and most western European countries. Postmenopausal mortality rates are systematically higher in eastern Europe, with death rates in the Ukraine, Latvia, Czech Republic, Russia and Belarus 2-3 times those seen in western Europe. Declining mortality trends are seen in most populations, though in certain Eastern European countries, the declines began rather recently, during the 1980s. In Belarus and Russia, recent postmenopausal death rates are stable or increasing. The rates are adjusted for misclassification of uterine cancer deaths but remain unadjusted for hysterectomy, and where there is an apparent levelling off of incidence or mortality rates recently, rising prevalence of hysterectomy cannot be discounted as an explanation. However, the trends by age group can be viewed in light of several established risk factors for endometrial cancer that are highly prevalent and most likely changing with time. These are discussed, as are the prospects for preventing the disease.     

2010-2014年浙江省肿瘤登记地区子宫体癌发病与死亡分析

目的近年来子宫体癌发病呈现明显上升趋势,为了解浙江省近年来女性子宫体癌流行现状,现分析2010-2014年浙江省肿瘤登记地区子宫体癌的发病与死亡情况。方法数据来源于浙江省肿瘤防治办公室14个登记处(浙江省)上报的子宫体癌发病、死亡和人口资料,分别计算发病(死亡)例数、粗发病率(死亡率)、构成比和顺位、中国标准人口构成(中标率)、Segi’s标准人口构成(世标率)、累积率、截缩率、年龄别发病率(死亡率)、发病率(死亡率)年度变化百分比(annual change percent change,APC)及95%CI等指标。结果2010-2014年浙江省14个肿瘤登记地区共报告子宫体癌新发病例2767例,占女性癌症新发病例的3.08%。子宫体癌发病率为9.46/10万,中标率为6.11/10万,位居女性癌症发病顺位的第8位。子宫体癌发病率呈波动增长趋势,从2010年的9.31/10万上升至2014年的10.28/10万,APC为1.89%(95%CI:-2.90~6.91)。2010-2014年共报告子宫体癌死亡病例797例,占女性癌症死亡病例的2.10%。子宫体癌死亡率为2.72/10万,中标率为1.58/10万,位居女性癌症死因顺位的第13位。子宫体癌死亡率呈现波动下降趋势,由2010年的2.76/10万降至2014年的2.52/10万,APC为-4.28%(95%CI:-13.82~6.33)。结论浙江省子宫体癌发病率呈波动上升趋势,但死亡率呈波动下降趋势,应通过提高早诊早治比例、提高女性自我防护意识和倡导健康生活方式等综合措施做好子宫体癌防控。     

Long-term survival experience of female patients with genital cancer

Survival analyses of patients with cancer of the cervix uteri, corpus uteri or ovary registered at Cambridge in 1960-1979 show that, although the long-term survivors had mortality rates similar to those of a normal age-matched population and might therefore be considered 'statistically cured', their risk of dying from their original cancer was still much higher than normal. Death rates from other cancers were slightly increased in cervix patients but not in corpus and ovary. At all three sites there was no evidence that deaths from non-malignant causes were increased. Only in cancer of the ovary was survival significantly better for patients registered in 1970-1979 than for patients registered in 1960-1969.     

上海市区女性生殖系统恶性肿瘤发病趋势分析

目的对1972～1999年上海市区常见的女性生殖系统恶性肿瘤的发病率进行统计,分析其发病趋势及变化原因,为防治措施的制定提供依据.方法根据上海市肿瘤发病登记处收集的1972～1999年的上海市区卵巢癌、宫颈癌、宫体癌和不明部位子宫癌的病例资料和相应年份的人口资料,分别计算各年龄组的年龄别发病率.并采用直接法计算世界人口标化发病率,对数线性回归法计算标化率的年变化率(Annual percentage change,APC),并对病例数进行加权计算.结果1972～1999年上海市肿瘤登记处共登记卵巢癌6106例、宫颈癌8063例,宫体癌3 933例和不明部位子宫癌1 312例.28年来,宫体癌和卵巢癌的标化发病率呈上升趋势,分别从1972～1974年的2.49/10万和4.77/10万上升至1996～1999年的4.75/10万和6.88/10万,年增长率分别为3.0%和2.0%.同期宫颈癌的标化发病率从26.66/10万快速下降至2.18/10万,年下降率达10.5%.不明部位子宫癌的标化发病率亦呈下降趋势(P＜0.01).宫体癌以55～64和65～74岁组发病率上升最快,年增长率分别为2.5%和3.3%.卵巢癌各年龄组的发病率均有上升趋势,年变化率都在1.0%以上.宫颈癌发病率下降最快的年龄组是45～54和55～64岁组,25～34和35～44岁组的发病率在近几年有升高趋势.结论上述肿瘤的发病率及年龄别发病率的变化趋势提示,上海女性生活方式和环境因素的改变可能是导致这种变化的重要原因.     

Alternate ranging methods for cancer mortality maps

BACKGROUND: Mapping techniques can highlight the spatial or temporal variations in rates of cancer mortality. In mapping geographic patterns of cancer mortality, spatial units are grouped into categories defined by specified rate ranges, and then the units in each category are assigned a particular color in the map. We examined the consequences of using different ranging methods when comparing maps over several time intervals. METHODS: Maps of mortality rates for cancers of the breast, lung (including the lung, trachea, bronchus, and pleura), and cervix uteri in the United States by county or state economic area are created for different time intervals between 1950 and 1994. Two ranging methods are employed: 1) Ranges are defined for individual time interval by the deciles of rates in that interval (ranging within intervals), and 2) constant ranges for all time intervals are defined by the deciles of rates for the entire 45-year period from 1950 through 1994 (ranging across intervals). The time intervals from 1950 through 1969 and from 1970 through 1994 were chosen to accommodate the availability of detailed county-level population estimates specifically for blacks starting in 1970. RESULTS: The ranging method has little impact on maps for breast cancer mortality, which changed little over time. For lung cancer, which increased over time, and cervix uteri cancer, which decreased over time, ranging within time intervals shows the geographic variability but does not convey the temporal trends. Trends are evident when ranging across time intervals is employed; however, geographic variability is partially obscured by the predominance of spatial units in the highest rate categories in the recent time intervals for lung cancer and in the early time intervals for cervix uteri cancer. CONCLUSIONS: Ranging within time intervals displays geographic patterns and changes in geographic patterns, regardless of time trends in rates. Ranging across time intervals shows temporal changes in rates but with some loss of information about geographic variability.     

Cervical Adenocarcinoma and Squamous Cell CarcinomaIncidence Trends among Tunisian Women

Introduction: Uterine cervix cancer is an important public health problem in Tunisia. In this study, we reporttrends in the incidence of adenocarcinoma and squamous cell carcinoma of the cervix uteri in the central regionof Tunisia during 1993-2006. Design: Data were obtained from the Cancer Registry of the Center of Tunisiawhich registers invasive cancer cases by active methods. Five-year age-specific rates, crude incidence rates (CR),world age-standardized rates (ASR), percent change (PC) and annual percent change (APC) were calculatedusing annual population data. Results: Among all women cancers, cervix uteri cancer accounted for 5.9% andranked the fourth during the study period with an ASR of 6.9 per 100,000. The ASRs decreased notably with anAPC of -6.7% over the whole period. However, incidence rates of adenocarcinomas have increased during thelast years (APC: +14.4%). Conclusion: The introduction of cytological screening programs has led to a markeddecrease of the incidence rates of cervix uteri cancer among Tunisian women. The data underline the fact thatthe population-based cancer registry is an indispensable tool for providing data for planning and evaluation ofprograms for cancer control.     

Time trends in cancer mortality in China: 1987-1999

A first analysis of time trends in cancer mortality in China at the national level is presented. Using a joinpoint regression model, based on data from a national mortality routine reporting system in China (CHIS), time trends in mortality for 9 major cancers are analyzed. Between 1987 and 1999, the age-standardized mortality rates for all cancers combined declined slightly in rural areas but have increased since 1996 in urban areas. The mortality rates for cancers in oesophagus, stomach, cervix uteri, leukaemia (except for urban males after 1996) and nasopharynx declined, while lung cancer and female breast cancer showed significant increasing trends in both urban and rural areas and for both sexes. Cancers of the colon-rectum and liver had different trends in mortality in urban and rural populations. The trends in age-specific mortality rates suggest some different trends in the younger population, which may presage future overall trends, for example, increasing mortality from cancer of the cervix. The observed trends primarily reflect the dramatic changes in socioeconomic circumstances and lifestyles in China in the last 2 decades. Tobacco smoking remains a major problem, with increases in mortality from lung cancer. The improvements in socioeconomic status, diet and nutrition may be responsible for the declining risk of some cancers (oesophagus, stomach and nasopharynx), while increasing the risk for others (breast and colon-rectum). Screening programs (especially for cervix cancer), and more available and better facilities for cancer therapy, may have helped to reduce mortality for several cancers. The large increases in the absolute number of deaths that resulted from the increasing and aging population are much more important in determining the future cancer burden than any changes due to change in risk, emphasizing the increasing importance of cancer as a health problem in the 21st century in China.     

Comparison of time trends in uterine cancer incidence (1973 1997) in East Asia, Europe and USA, from Cancer Incidence in Five Continents, Vols IV VIII

Time trends of age-standardized rate (ASR) of uterine cancerincidence (ICD-10: cervix uteri (C53), corpus uteri (C54)) werecompared among 18 selected cancer registries and ethnic/racialgroups in East Asia, Europe and the USA. The data source wasthe Cancer Incidence in Five Continents, Vols IV–VIII(years at diagnosis: 1973–1977, 1978–1982, 1983–1987,1988–1992 and 1993–1997, respectively). World populationwas used for age-standardization. Figure 1 shows the time trends of ASR of cervix uteri cancerincidence. In East Asia,     

Incidence trends for cancers of the breast,ovary, and corpus uteri in urban Shanghai, 1972–89

Incidence data from the Shanghai (People's Republic of China) Cancer Registry were used to assess the temporal trends of three major female cancers during 1972–89. Rates for cancers of the breast, corpus uteri and, to a lesser extent, ovary rose over the study period. The increases in breast and ovarian cancer were most pronounced among women under age 50, whereas those for corpus uteri cancer were restricted generally to those aged 55 to 69 years. When considered by cohort year of birth, risk of breast and ovarian cancers rose among women born since 1925 and 1935, respectively, but little evidence of cohort effect was apparent for corpus uteri cancer. Potential explanations for these patterns are explored.