Cervical Cancer Trends in the United States: A 35-Year Population-Based Analysis
Cervical Cancer Trends in the United States: A 35-Year Population-Based Analysis
复制标题
美国宫颈癌趋势： 基于人口的 35 年分析
DOI：
10.1089/jwh.2011.3385
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发表时间：
2012-10-01
影响因子：
3.5
通讯作者：
Virnig, Beth
中科院分区：
文献类型：
--
作者：
Adegoke, Olusola;Kulasingam, Shalini;Virnig, Beth
目的：为了分析浸润性宫颈癌发病率的趋势，年龄，组织学，和种族超过35年的时间（1973-2007年），以了解宫颈癌的表现形式的变化：9个监测，流行病学和最终结果（SEER）登记处，连续收集信息浸润性宫颈癌的数据进行了分析的趋势。以2000年美国人口为标准，按种族和组织学亚型估计年龄校正的年发病率。组织学亚型分为鳞状、腺癌和腺鳞状。35年来，浸润性宫颈癌的总体发病率从13.07/10万下降了54%（1973-1975）降至6.01/10万（2006-2007），白人和黑人的发病率分别下降了51%和70.2%。鳞癌发病率从1973-1975年的10.2/10万下降到2006-2007年的3.97/10万，下降了61.1%。腺鳞状细胞癌的发病率从0.27/10万下降了16%，（1973-1975年）至0.23/100，000腺癌的发病率从1973-1975年的1.09/100，000上升到2006 - 2007年的1.44/100，000，上升了32.2%。腺癌的增加是由于发病率的增加，在白色妇女的发病率下降，观察到为黑人women.Conclusions：虽然显着减少的整体和种族特异性的发病率浸润性宫颈癌已经实现，他们掩盖了重要的变化，组织学亚型。这些研究结果表明，如果要控制宫颈腺癌，则需要优先考虑巴氏涂片筛查的替代方案，如人乳头瘤病毒（HPV）检测和HPV疫苗接种。
Purpose: To analyze trends in invasive cervical cancer incidence by age, histology, and race over a 35-year period (1973-2007) in order to gain insight into changes in the presentation of cervical cancer.Methods: Data from the nine Surveillance, Epidemiology, and End Results (SEER) registries that continuously collected information on invasive cervical cancer were analyzed for trends. Standardized to the 2000 U.S population, annual age-adjusted incidence rates were estimated by race and histologic subtype. Histologic subtype was classified into squamous, adenocarcinoma, and adenosquamous.Results: Overall incidence rates for invasive cervical cancer decreased by 54% over the 35 years, from 13.07/100,000 (1973-1975) to 6.01/100,000 (2006-2007), and the incidence rates declined by 51% and 70.2%, respectively, among whites and blacks. The incidence rates for squamous carcinoma decreased by 61.1% from 10.2/100,000 (1973-1975) to 3.97/100,000 (2006-2007). Incidence rates for adenosquamous cell carcinomas decreased by 16% from 0.27/100,000 (1973-1975) to 0.23/100,000 (2006-2007), and incidence rates for adenocarcinomas increased by 32.2% from 1.09/100,000 (1973-1975) to 1.44/100,000 (2006-2007). This increase in adenocarcinomas was due to an increase in incidence in white women; a decrease in incidence was observed for black women.Conclusions: Although marked reductions in the overall and race-specific incidence rates of invasive cervical cancer have been achieved, they mask important variation by histologic subtype. These findings suggest that alternatives to Pap smear-based screening, such as human papillomavirus (HPV) testing and HPV vaccination, need to be prioritized if adenocarcinomas of the cervix are to be controlled.