Rapid increase in endometrial cancer incidence and ethnic differences in New Zealand

Scott, Oliver William; Tin, Sandar Tin; Bigby, Susan M.; Elwood, J. Mark

doi:10.1007/s10552-019-1129-1

Cited by 28 publications

(24 citation statements)

References 21 publications

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“…Our study highlights the burden of EC in this high‐risk community, where incidence rates and time trends were substantially worse than those reported for all NZ women. The APC in incidence of 7.3 (95% CI 3.6–11.1) over the 15‐year study period exceeds the most recently reported national APC of 2.01 (95% CI 1.40–2.60), and is attributed largely to the high rates in Pacific women. The RR of EC with reference to ‘Other’ women (RR = 1) was 2.47 in Māori women and 5.11 in Pacific women.…”

Section: Discussioncontrasting

confidence: 55%

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

Bigby

Tin

Eva

et al. 2020

Aust NZ J Obst Gynaeco

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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

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Section: Discussioncontrasting

confidence: 55%

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

Bigby

Tin

Eva

et al. 2020

Aust NZ J Obst Gynaeco

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“…Thus, data concerning the EC burden estimates and trends in different regions and countries may be valuable for decision-making and resource allocation. However, previous studies to date have mainly focused on single countries or regions, EC trends over a limited period, and there has been only one study published on the international patterns and trends of EC incidence (10,11). Therefore, in this study, we report the results of the Global Burden of Disease (GBD) 2017 study on primary EC incidence, prevalence, mortality, disability-adjusted life years (DALYs), years of life lived with disability (YLDs), and years of life lost (YLLs) for 195 countries or territories from 1990 to 2017 and assess the association between these indicators of the disease burden and the SDI level.…”

Section: Introductionmentioning

confidence: 99%

Global, Regional, and National Burden of Endometrial Cancer, 1990–2017: Results From the Global Burden of Disease Study, 2017

et al. 2019

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Endometrial cancer (EC) is the most common malignancy affecting women in developed countries. Recently, the EC disease burden has changed; therefore, the Global Burden of Disease (GBD) 2017 was used to comprehensively analyze the global, regional, and national burden of EC between 1990 and 2017. General GBD cancer estimation methods were used with the data input from vital registration systems and cancer registries. Annual percent changes were calculated to quantify the trends of EC burden estimates during the study period. Furthermore, the sociodemographic index (SDI) was used to assess the relationship between the EC burden estimates and development level. From 1990 to 2017, the age-standardized incidence and prevalence rate of EC increased globally by 0.58 and 0.89% per year, respectively. In contrast, the age-standardized death rate and disability-adjusted-life years (DALYs) decreased by 1.19 and 1.21% per year, respectively. Increasing trends in both the incidence and prevalence were observed in all SDI quintiles, except for the low SDI quintiles, whereas decreasing trends were observed in all SDI quintiles for mortality and DALYs. Additionally, a non-linear association existed for the level of mortality rate, DALYs, and SDI. Of note, there was a strong positive association between a high body mass index and DALYs across all SDI quintiles. In conclusion, EC incidence and prevalence rates are growing globally, whereas the death rate and DALYs decreased between 1990 and 2017. Greater efforts, particularly detailed prevention strategies for reducing obesity, should be performed to reverse this phenomenon.

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“…EC is a relevant gynecological malignancy which occurs in fertile and postmenopausal women. The mean age of women affected by this tumor is decreasing; thus, the incidence in worldwide women under 40 years of age is on the rise (21). EC is linked to obesity (21), and the pandemic of obesity is a global threat.…”

Section: Focus On Ecmentioning

confidence: 99%

“…The mean age of women affected by this tumor is decreasing; thus, the incidence in worldwide women under 40 years of age is on the rise (21). EC is linked to obesity (21), and the pandemic of obesity is a global threat. Patients with EC have a good prognosis at early-stage incidence, while the prognosis for recurrent or metastatic EC remains poor (22).…”

Section: Focus On Ecmentioning

confidence: 99%

Endometrial Cancer Immune Escape Mechanisms: Let Us Learn From the Fetal–Maternal Interface

Bruno¹,

Corrado

Baci

et al. 2020

Front. Oncol.

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The immune escape mechanisms at the base of tumor progression in endometrial cancer mimic immune tolerance mechanisms occurring at the maternal-fetal interface. The biological and immunological processes behind the maternal-fetal interface are finely tuned in time and space during embryo implantation and subsequent pregnancy stages; conversely, those behind cancer progression are often aberrant. The environment composition at the maternal-fetal interface parallels the pro-tumor microenvironment identified in many cancers, pointing to the possibility for the use of the maternal-fetal interface as a model to depict immune therapeutic targets in cancer. The framework of cancer environment signatures involved in immune adaptations, precisely timed in cancer progression, could reveal a specific "immune clock" in endometrial cancer, which might guide clinicians in patient risk class assessment, diagnostic workup, management, surgical and therapeutic approach, and surveillance strategies. Here, we review studies approaching this hypothesis, focusing on what is known so far about oncofetal similarities in immunity with the idea to individualize personalized immunotherapy targets, through the downregulation of the immune escape stage or the reactivation of the pro-inflammatory processes suppressed by the tumor.

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Rapid increase in endometrial cancer incidence and ethnic differences in New Zealand

Cited by 28 publications

References 21 publications

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

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

Global, Regional, and National Burden of Endometrial Cancer, 1990–2017: Results From the Global Burden of Disease Study, 2017

Endometrial Cancer Immune Escape Mechanisms: Let Us Learn From the Fetal–Maternal Interface

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