Incidence and mortality of gynaecological cancers: Secular trends in urban Shanghai, China over 40 years

Abstract

Aim Appraisal of cancer trends is essential for future cancer control, but relevant studies in China are scarce due to a lack of long-term data. With 40-years of cancer registry data, we sought to evaluate secular time trends in incidence and mortality of gynecological cancers in an urban Chinese population. Materials and methods Data on incidence and mortality of invasive cervical, uterine and ovarian cancer were collected by the Shanghai Cancer Registry. Age-standardized incidence and mortality rates were calculated for women aged 20–84 in urban Shanghai between 1973 and 2012. Age-period-cohort Poisson regression models were used to evaluate age, period and cohort effects. Overall linear trends, interpreted as the estimated annual percentage change (EAPC), were derived from the net drift in age-drift models. Results Overall, cervical cancer incidence and mortality substantially decreased (EAPC=−4.5% and −5.5%, respectively); however, an upward trend was apparent among younger women (age<60). Uterine cancer incidence increased slightly (EAPC=1.8%), while mortality decreased over time (EAPC=−2.4%). Ovarian cancer incidence and mortality both increased, although the increase in incidence (EAPC=1.8%) was larger than mortality (EAPC=0.6%). While cohort effects were most evident for cervical cancer incidence and mortality, significant age, period, and cohort effects were found for all three gynecological cancers evaluated. Conclusions These secular trends in incidence and mortality of gynecological cancers in Shanghai likely reflect changing risk factor profiles and improved cancer prognosis over time, and suggest new priorities and call for additional efforts for gynecological cancer prevention and control for women in China.

Time Trends in the Incidence and Mortality of Ovarian Cancer in Ireland, Northern Ireland, and Israel, 1994–2013

“…4,17,18 In some countries, the trends were stable, 19Y22 whereas in others they increased. 23,24 The decreasing incidence trends in Ireland, NI (since 1998), and Israeli Jews are in accordance with observations for other high-background-incidence countries (eg, the United States). Decreases in incidence may be the result of a change in the structure of a population 4 ; however, they most likely reflect changing patterns of certain exposures.…”

“…23,54,55 In most other countries, mortality rates are decreasing 4,18,19,56 or stable. 17,23,54 The current study showed significantly decreasing mortality trends during the period 1994Y2013 in Ireland, NI (since 2005), and Israeli Jews, which are consistent with the observations for other high-background-mortality countries (ie, the United States, for the period 1975Y2011).…”

Cancer mortality trends in an industrial district of Shanghai, China, from 1974 to 2014, and projections to 2029

“…Imbalance of economic development and diversity of lifestyles contribute to apparent differences in the incidences and mortalities of cancer types in different areas of China. Although estimates of cancer burden in China have been reported, the assumptions are limited to a snapshot of the patterns by cancer site in a given year [ 3 – 6 ] or to longitudinal situations of specific cancers and all cancer types for relatively short durations [ 7 – 11 ], making comparisons of long-term trends across all cancer types in accordance with economic development and lifestyle changes difficult.…”

Ovarian Cancer Incidence in the Multi-Ethnic Asian City-State of Singapore 1968-2012

“…Ovarian cancer mortality from 1979-2010 has remained stable in Hong Kong and Singapore, although it increased in South Korea (Lee et al, 2014). In Shanghai, China, over a 40-year period, ovarian cancer incidence has increased on average 1.8% per annum (Huang et al, 2016). A study in Niigata prefecture also showed increasing rates of ovarian cancers, and in particular for mucinous and clear cell adenocarcinomas (Yahata et al, 2012).…”

“…Internationally, it is the 7th most common cancer among women, contributing 2.4% of all incident cases of cancer among women, and accounting for 4.4% of all cancer deaths (International Agency for Research in Cancer [IARC], 2012). In many countries across Asia, the incidence of ovarian cancer has been rising (Lee et al, 2014;Huang et al, 2016). In Singapore, ovarian cancer is the 5th most common female cancer, constituting 5.4% of new cancer cases and 5.1% of all female cancer deaths.…”