Akhtar-Danesh Noori, Elit Laurie, Lytwyn Alice
School of Nursing, McMaster University, Hamilton, Ontario, Canada; Department of Clinical Epidemiology & Biostatistics, McMaster University, Hamilton, Ontario, Canada.
Department of Clinical Epidemiology & Biostatistics, McMaster University, Hamilton, Ontario, Canada; Department of Obstetrics and Gynecology, McMaster University, Hamilton, Ontario, Canada.
Gynecol Oncol. 2014 Aug;134(2):314-8. doi: 10.1016/j.ygyno.2014.05.014. Epub 2014 May 26.
The aim of this study is to estimate trends in incidence and relative survival in women diagnosed with invasive squamous cell vulvar cancer in the United States (U.S.) and Canada over the periods of 1973-2010 for U.S. and 1992-2008 for Canada.
We identified patients with primary invasive squamous cell vulvar cancers in the Surveillance, Epidemiology, and End Results cancer registry database and the Canadian Cancer Registry dataset. Women younger than 40 years were excluded because of the small number of patients in this age group. A flexible parametric model was used to estimate two- and five-year relative survival ratios and excess mortality rate.
In total 15,041 patients diagnosed with invasive squamous cell vulvar cancer were included in this analysis. The incidence rate of vulvar cancer increased in both U.S. and Canada. Two- and five-year relative survival ratios decreased over time for both countries, particularly for patients 80 years and over.
The incidence rate of invasive vulvar cancer continued to increase in U.S. and Canada while its two- and five-year relative survival ratios gradually decreased for all age groups over the last few decades. Also, excess mortality rate reaches to its peak after about 6 months from diagnosis and then starts to decline. This is the first report that examine relative survival ratio for vulvar cancer in Canada and U.S. and serves as a basis for future similar studies.
本研究旨在评估1973 - 2010年美国及1992 - 2008年加拿大确诊为浸润性外阴鳞状细胞癌的女性的发病率及相对生存率趋势。
我们在监测、流行病学及最终结果癌症登记数据库和加拿大癌症登记数据集中确定了原发性浸润性外阴鳞状细胞癌患者。因该年龄组患者数量较少，将40岁以下女性排除。采用灵活参数模型估计两年和五年相对生存率及超额死亡率。
本分析共纳入15,041例确诊为浸润性外阴鳞状细胞癌的患者。美国和加拿大的外阴癌发病率均有所上升。两国的两年和五年相对生存率均随时间下降，尤其是80岁及以上患者。
在过去几十年中，美国和加拿大浸润性外阴癌的发病率持续上升，而所有年龄组的两年和五年相对生存率逐渐下降。此外，超额死亡率在诊断后约6个月达到峰值，然后开始下降。这是首份研究美国和加拿大外阴癌相对生存率的报告，为未来类似研究奠定了基础。
