Increased age and race-specific incidence of cervical cancer after correction for hysterectomy prevalence in the United States from 2000 to 2009.
Increased age and race-specific incidence of cervical cancer after correction for hysterectomy prevalence in the United States from 2000 to 2009.
复制标题
对 2000 年至 2009 年美国子宫切除术流行率进行校正后，特定年龄和种族的宫颈癌发病率有所增加。
DOI：
10.1002/cncr.28548
复制
发表时间：
2014-07-01
期刊：
影响因子：
6.2
通讯作者：
Gravitt, Patti E.
中科院分区：
文献类型：
--
作者：
Rositch, Anne F.;Nowak, Rebecca G.;Gravitt, Patti E.
关键词：
据认为，65岁以上的妇女中浸润性宫颈癌的发病率会下降，65岁是建议停止常规宫颈癌筛查的年龄。然而，全国宫颈癌发病率并不能解释美国子宫切除术的高流行率。使用行为危险因素监测系统（BRFSS）的子宫切除术患病率估计值，根据2000年至2009年美国监测、流行病学和最终结果（SEER）18登记处计算子宫切除术校正的年龄标准化和年龄特异性宫颈癌发病率。使用Joinpoint回归分析了不同年龄段的校正宫颈癌发病率趋势。与未校正率的相对下降不同，校正率在35-39岁后继续增加（APCCORRECTED = 10.43），但速度低于20-34岁（APCCORRECTED = 161.29）。最高的校正发病率是在65至69岁的妇女中，每10万妇女中有27.4例，而40至44岁的最高未校正发病率为每10万妇女中有15.6例。子宫切除术的矫正对老年黑人妇女的影响最大，因为她们的子宫切除术患病率很高。子宫切除术的矫正导致了更高的年龄特异性宫颈癌发病率，发病高峰转移到老年妇女，以及黑人和白色妇女之间宫颈癌发病率的差异增加。鉴于60至65岁妇女的宫颈癌发病率很高且没有下降，当妇女有资格退出筛查时，可能需要重新考虑老年妇女宫颈癌的风险和筛查指南。
Invasive cervical cancer is thought to decline in women over 65 years old, the age at which cessation of routine cervical cancer screening is recommended. However, national cervical cancer incidence rates do not account for the high prevalence of hysterectomy in the United States. Using estimates of hysterectomy prevalence from the Behavioral Risk Factor Surveillance System (BRFSS), hysterectomy-corrected age-standardized and age-specific incidence rates of cervical cancer were calculated from the Surveillance, Epidemiology, and End Results (SEER) 18 registry in the United States from 2000 to 2009. Trends in corrected cervical cancer incidence across age were analyzed using Joinpoint regression. Unlike the relative decline in uncorrected rates, corrected rates continue to increase after age 35–39 (APCCORRECTED = 10.43) but at a slower rate than in 20–34 years (APCCORRECTED = 161.29). The highest corrected incidence was among 65- to 69-year-old women, with a rate of 27.4 cases per 100,000 women as opposed to the highest uncorrected rate of 15.6 cases per 100,000 aged 40 to 44 years. Correction for hysterectomy had the largest impact on older, black women given their high prevalence of hysterectomy. Correction for hysterectomy resulted in higher age-specific cervical cancer incidence rates, a shift in the peak incidence to older women, and an increase in the disparity in cervical cancer incidence between black and white women. Given the high and nondeclining rate of cervical cancer in women over the age of 60 to 65 years, when women are eligible to exit screening, risk and screening guidelines for cervical cancer in older women may need to be reconsidered.
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