1 EndoRheum Consultants, LLC , Malvern, Pennsylvania.
2 Consultant to EndoRheum Consultants, LLC , Malvern, Pennsylvania.
J Womens Health (Larchmt). 2019 Feb;28(2):237-243. doi: 10.1089/jwh.2018.6956. Epub 2018 Nov 28.
The Surveillance, Epidemiology, and End Result (SEER) database shows a variable increase in endometrial cancer incidence over time. The objective of this review was to examine published endometrial cancer rates and potential etiologies.
Endometrial cancer incidence was obtained from the SEER Program database from 1975 through 2014, and a test for trend in incidence was calculated. Changes in risk factors thought to be associated with endometrial cancer, including age, obesity, diabetes, diet and exercise, reproductive factors, and medications (hormone therapy [HT] including Food and Drug Administration [FDA]-approved and non-FDA-approved [compounded] estrogens and progestogens, tamoxifen, and hormonal contraceptives) were found through PubMed searches. Temporal trends of risk factors were compared with endometrial cancer trends from SEER.
Although endometrial cancer rates were constant from 1992 to 2002 (women 50-74 years of age), they increased 2.5% annually with a 10% increase from 2006 to 2012 (trend test 0.82). Use of approved prescription estrogen-progestogen combination products decreased after the publication of the Women's Health Initiative (WHI) data, whereas other risk factors either remained constant or decreased during the same time; however, compounded bioidentical HT (CBHT) use increased coincident with the endometrial cancer increase.
Endometrial cancer rate increases after the first publication of WHI data in 2002 may be associated with the decreased use of approved estrogen-progestogen therapy, the increase in CBHT use, and the prevalence of obesity and diabetes; potential relationships require further evaluation.
监测、流行病学和最终结果（SEER）数据库显示，子宫内膜癌的发病率随时间呈变化性增长。本研究旨在评估已发表的子宫内膜癌发病率和潜在病因。
从 1975 年至 2014 年，SEER 项目数据库中获取子宫内膜癌发病率数据，并计算发病率的趋势检验。通过 PubMed 搜索，发现与子宫内膜癌相关的危险因素（包括年龄、肥胖、糖尿病、饮食和运动、生殖因素以及药物[激素治疗（HT）包括食品和药物管理局（FDA）批准和非 FDA 批准[复合]雌激素和孕激素、他莫昔芬和激素避孕药]）发生了变化。将危险因素的时间趋势与 SEER 中的子宫内膜癌趋势进行比较。
尽管 1992 年至 2002 年（50-74 岁女性）子宫内膜癌的发病率保持不变，但从 2006 年至 2012 年，每年增加 2.5%，呈 10%的递增（趋势检验 0.82）。在妇女健康倡议（WHI）数据发布后，批准的处方雌激素-孕激素联合产品的使用减少，而其他危险因素在同一时期保持不变或减少；然而，复合生物等效 HT（CBHT）的使用增加与子宫内膜癌的增加同时发生。
WHI 数据首次发布后，2002 年子宫内膜癌的发病率增加可能与批准的雌激素-孕激素治疗的减少、CBHT 使用的增加以及肥胖和糖尿病的流行有关；潜在的关系需要进一步评估。
