Arbyn Marc, Antoine Jerome, Valerianova Zdravka, Mägi Margit, Stengrevics Aivars, Smailyte Giedre, Suteu Ofelia, Micheli Andrea
Unit of Cancer Epidemiology Scientific Institute of Public Health, Brussels, Belgium.
Tumori. 2010 Jul-Aug;96(4):517-23. doi: 10.1177/030089161009600402.
The burden of cervical cancer varies considerably in the European Union. In this paper, we describe trends in incidence of and mortality from this cancer in the five most affected member states.
Data on number of deaths from uterine cancers and the size of the female population of Estonia, Latvia, Lithuania, Bulgaria and Romania were extracted from the WHO mortality database. Mortality rates were corrected for inaccuracies in the death certification of not otherwise specified uterine cancer. Incidence data were obtained from the national cancer registries. Joinpoint regression was used to study the annual variation of corrected and standardized incidence and mortality rates. Changes by birth cohort were assessed for specific age groups and subsequently synthesized by computing standardized cohort incidence/mortality ratios.
Joinpoint regression revealed rising trends of incidence (in Lithuania, Bulgaria and Romania) and of mortality (in Latvia, Lithuania, Bulgaria and Romania). In Estonia, rates were rather stable. Women born between 1940 and 1960 were at continuously increasing risk of both incidence of and mortality from cervical cancer.
Rising trends of cervical cancer in the most affected EU member states reveal a worrying pattern that warrants urgent introduction of effective preventive actions as described in the European guidelines.
子宫颈癌负担在欧盟各国差异很大。在本文中，我们描述了五个受影响最严重的成员国中该癌症的发病率和死亡率趋势。
从世界卫生组织死亡率数据库中提取爱沙尼亚、拉脱维亚、立陶宛、保加利亚和罗马尼亚子宫癌死亡人数及女性人口规模的数据。对未另行说明的子宫癌死亡证明中的不准确之处进行了死亡率校正。发病率数据来自国家癌症登记处。采用连接点回归研究校正后的标准化发病率和死亡率的年度变化。评估特定年龄组出生队列的变化，随后通过计算标准化队列发病率/死亡率比值进行综合分析。
连接点回归显示发病率（立陶宛、保加利亚和罗马尼亚）和死亡率（拉脱维亚、立陶宛、保加利亚和罗马尼亚）呈上升趋势。在爱沙尼亚，发病率相当稳定。1940年至1960年出生的女性患子宫颈癌的发病率和死亡率持续上升。
受影响最严重的欧盟成员国中子宫颈癌发病率上升趋势揭示了一种令人担忧的模式，需要按照欧洲指南的要求紧急采取有效的预防措施。
