Bray Freddie, Loos Anja H, Oostindier Mariet, Weiderpass Elisabete
Non-communicable Disease Epidemiology Group, International Agency for Research on Cancer, Lyon, France.
Int J Cancer. 2005 Oct 20;117(1):123-31. doi: 10.1002/ijc.21099.
Corpus uteri cancer is the fourth most common neoplasm in women in Europe and the tenth most common cause of cancer death. We examined geographic and temporal variations in corpus uteri cancer incidence and mortality rates in the age groups 25-49 and 50-74 in 22 European countries. The disease is considerably less common in premenopausal women, with incidence and mortality rates decreasing throughout Europe and mortality declines more marked in western and southern European countries. Incidence rates among postmenopausal women are highest in the Czech Republic, Slovakia, Sweden and Slovenia and lowest in France and the United Kingdom. Increasing incidence trends in this age group are observed in the Nordic countries (except Denmark) and in the United Kingdom. Some increases are also seen in eastern (Slovakia) and southern Europe (Spain and Slovenia), while relatively stable or modestly decreasing trends are observed in Italy and most western European countries. Postmenopausal mortality rates are systematically higher in eastern Europe, with death rates in the Ukraine, Latvia, Czech Republic, Russia and Belarus 2-3 times those seen in western Europe. Declining mortality trends are seen in most populations, though in certain Eastern European countries, the declines began rather recently, during the 1980s. In Belarus and Russia, recent postmenopausal death rates are stable or increasing. The rates are adjusted for misclassification of uterine cancer deaths but remain unadjusted for hysterectomy, and where there is an apparent levelling off of incidence or mortality rates recently, rising prevalence of hysterectomy cannot be discounted as an explanation. However, the trends by age group can be viewed in light of several established risk factors for endometrial cancer that are highly prevalent and most likely changing with time. These are discussed, as are the prospects for preventing the disease.
子宫体癌是欧洲女性中第四大常见肿瘤，也是癌症死亡的第十大常见原因。我们研究了22个欧洲国家25 - 49岁和50 - 74岁年龄组子宫体癌发病率和死亡率的地理和时间变化。该疾病在绝经前女性中相当少见，在整个欧洲发病率和死亡率都在下降，在西欧和南欧死亡率下降更为明显。绝经后女性的发病率在捷克共和国、斯洛伐克、瑞典和斯洛文尼亚最高，在法国和英国最低。在北欧国家（丹麦除外）和英国观察到该年龄组发病率呈上升趋势。在东欧（斯洛伐克）和南欧（西班牙和斯洛文尼亚）也有一些上升，而在意大利和大多数西欧国家观察到相对稳定或略有下降的趋势。东欧绝经后死亡率系统性地更高，乌克兰、拉脱维亚、捷克共和国、俄罗斯和白俄罗斯的死亡率是西欧的2 - 3倍。大多数人群的死亡率呈下降趋势，不过在某些东欧国家，下降始于20世纪80年代，时间较晚。在白俄罗斯和俄罗斯，近期绝经后死亡率稳定或上升。这些比率针对子宫癌死亡的错误分类进行了调整，但仍未针对子宫切除术进行调整，而且在最近发病率或死亡率明显趋于平稳的情况下，子宫切除术患病率上升不能被排除为一种解释。然而，根据子宫内膜癌的几个既定风险因素来看各年龄组的趋势，这些因素非常普遍且很可能随时间变化。文中对这些因素进行了讨论，还探讨了预防该疾病的前景。
