Increasing incidence of endometrial carcinoma in a high‐risk New Zealand community

Abstract

Background: Endometrial carcinoma (EC) is increasing in incidence, attributed largely to the obesity epidemic. Ethnic differences in New Zealand have long been recognised, with Pacific women bearing the greater burden of disease. We hypothesise that the pooled national incidence rates underestimate the true burden of EC in our high-risk community.Aims: We aimed to: (1) determine the incidence, trends and outcome of EC in the high-risk community served by our hospital, relative to national data; and (2) examine associated demographic, and clinicopathological features with reference to risk factors, to identify potential clinical and population intervention points. Materials and Methods: All area-resident women treated for EC at MiddlemoreHospital from 2000 to 2014 were identified from records, and clinicopathological data obtained. Incidence and time trend analyses were performed with reference to tumour type, age and ethnicity. Results:The study included 588 women. Pacific, followed by Māori, women had the highest incidence of EC (relative risk = 5.11 and 2.47, respectively, relative to 'Other' women). The incidence increased for all ethnicities (annual percentage change (APC) of 7.3; 95% CI 3.6-11.1), most marked in women aged below 50 years (APC of 12.2; 95% CI 5.2-19.7). This occurred predominantly in Pacific women, who had a high prevalence of potentially reversible risk factors. Disease-specific survival was worse in Pacific, and to a lesser extent, Māori women. Conclusions:Prompt investigation of symptomatic, high-risk women regardless of age may detect endometrial abnormalities at an early, potentially reversible stage.The prevention and management of identifiable high-risk factors would help mitigate the risk of EC and associated diseases. K E Y W O R D Sendometrial carcinoma, incidence trends, obesity, Pacific women, risk factors

Obesity and mortality among endometrial cancer survivors: A systematic review and meta‐analysis

“…Most of studies were conducted in Europe ( n = 20) 12,13,15,18,21,22,27,43–55 and North America ( n = 18) 19,20,23–26,56–67 . The remaining studies were conducted in Asia ( n = 4), 14,68–70 Oceania ( n = 2), 17,71 and South America ( n = 1) 72 . Only Martra et al 16 included participants from more than one location (USA and Italy).…”

“…Forest plot for the association of body mass index (kg/m 2 ) and endometrial cancer‐specific mortality among women with endometrial cancer stratified by endometrial cancer type (I/II). Note: reference group <25 kg/m 2 Fucinari et al (non‐Hispanic white), 67 Kolehmainen et al, 55 Mauland et al 21 ; 18.5–24.9 kg/m 2 Felix et al, 59 Nagle et al, 17 Van Arsdale et al, 25 ; 20–24.9 kg/m 2 Lindemann et al 18 ; <30 kg/m 2 Benedetti Panici et al, 48 Bigby et al, 71 Kurosu et al, 70 Matsuo et al, 63 Todo et al 68 …”

Beyond the numbers—understanding women’s experiences of accessing care for abnormal uterine bleeding (AUB): a qualitative study

“…There is a concerning and substantial growth of EC incidence in young, Pacific Island women, with almost half being diagnosed at premenopausal ages (<50 years). 6 EC incidence, morbidity and mortality rates in women who identify as Māori and Pasifika are much greater than those who identify as European/other. 7 8 Although AUB can have serious medical consequences and significantly impact women's daily life, 9 it is not a condition that…”

Effect of Radiotherapy in Addition to Surgery in Early Stage Endometrial Cancer: A Population-Based Study

“…In industrialized countries, endometrial cancer (EC) is the fourth most frequent cancer entity in women [1,2]. The global incidence of EC varies from 4.1/100,000 in less developed countries to an average of 34.1/100,000 in North America [3].…”