Gynecological cancer incidence in a hospital population in Saudi Arabia: the effect of foreign immigration over two decades

Aim:  To determine if the incidence of female genital malignancies changed with foreign immigration.
Methods  Retrospective analysis of histopathology records of women with primary genital tract cancers attending a referral gynecological hospital over two decades from 1985 to 2004. Incidence rates for the combined population of foreign migrants and Saudi nationals were compared to rates among Saudi nationals alone. Outcome measures were incidence rates and incidence rate ratios.
Results:  The incidence of cervical cancer for the combined migrant and local Saudi population was 48.4%, while for Saudi nationals alone it was 33.5% (incident rate ratio IRR]= 1.44, 95% CI 1.17–1.88, P  < 0.001). For vulvar cancer, the incidence was 1.2% versus 0.5% (IRR = 2.4, 95% CI 2.03–2.79, P  < 0.001). Endometrial cancer rate was lower in the combined population than in Saudi nationals alone (11.7% vs 18.0%, IRR = 0.65, 95% CI 0.27–1.02, P  < 0.04). There were no differences in incidence for gestational trophoblastic neoplasia, uterine corpus sarcoma, ovarian, and vaginal cancer. Incidence rate ratios differed between decades for cervical cancer (1.1/1.9, 0.58, 95% CI 0.21–0.89, P  < 0.001), vulvar cancer (4.2/1.8, 2.33, 95% CI 1.68–3.07, P  < 0.001), gestational trophoblastic neoplasia (1.4/1.0, 1.4, 95% CI 1.09–2.13, P  < 0.04), and uterine sarcoma (0.3/1.0, 0.03, 95% CI 0.012–0.041, P  < 0.02).
Conclusion:  The incidence of cervical and vulvar cancer increased among women presenting with gynecological malignancies. For cervical and vulvar cancer, uterine corpus sarcoma, and gestational trophoblastic neoplasia, incidence varied over time.