Surveillance and Health Services Research, American Cancer Society, Atlanta, GA, United States of America.
Surveillance and Health Services Research, American Cancer Society, Atlanta, GA, United States of America.
Prev Med. 2019 Jun;123:316-323. doi: 10.1016/j.ypmed.2019.04.010. Epub 2019 Apr 16.
Recent trends of cervical cancer incidence by histology and age in the United States (U.S.) have not been reported. We examined contemporary trends in cervical squamous cell carcinoma (SCC) and adenocarcinoma (AC) incidence rates in the U.S. by age group, race/ethnicity, and stage at diagnosis after accounting for hysterectomy. Incidence data (1999-2015) were obtained from the U.S. Cancer Statistics Incidence Analytic Database. Hysterectomy prevalence was estimated using National Health Interview Survey data (2000-2015). Overall SCC incidence rates continued to decrease in all racial/ethnic groups except among non-Hispanic whites in whom rates stabilized in the 2010s, largely driven by stable trends in ages <50 years and a slower pace of decrease in ages 50-59 years. After a stable trend between 1999 and 2002, AC incidence rates among non-Hispanic whites rose during 2002-2015 (1.3% per year), mostly due to increases in ages 40-49 (4.4% annually since 2004) and 50-59 years (5.5% annually since 2011). Overall AC incidence rates during 1999-2015 decreased in blacks and Hispanics but were stable in Asian/Pacific Islanders; in all these race/ethnicities, rates were generally stable in ages <50 years but decreasing in older ages. Rates of distant stage cervical SCC and AC among non-Hispanic whites increased in several age groups but were generally stable in non-whites. Increasing or stabilized incidence trends for AC and attenuation of earlier declines for SCC in several subpopulations underscore the importance of intensifying efforts to reverse the increasing trends and further reduce the burden of cervical cancer in the U.S.
美国（U.S.）宫颈癌的组织学和年龄发病趋势尚未有报道。本研究旨在分析美国宫颈癌鳞状细胞癌（SCC）和腺癌（AC）发病率的年龄组、种族/民族和诊断时的分期变化趋势，同时考虑了子宫切除术的影响。发病率数据（1999-2015 年）来自美国癌症统计分析数据库。子宫切除术的流行率使用国家健康访谈调查数据（2000-2015 年）进行估计。除非西班牙裔白人外，所有种族/民族的 SCC 发病率持续下降，而在非西班牙裔白人中，这一比例在 21 世纪 10 年代趋于稳定，这主要是由于年龄<50 岁的稳定趋势和 50-59 岁年龄组下降速度放缓所致。在 1999 年至 2002 年之间保持稳定趋势后，非西班牙裔白种人的 AC 发病率在 2002-2015 年期间上升（每年 1.3%），主要是由于年龄在 40-49 岁（自 2004 年以来每年增加 4.4%）和 50-59 岁（自 2011 年以来每年增加 5.5%）的增加所致。在黑人、西班牙裔和亚裔/太平洋岛民中，1999-2015 年期间的总体 AC 发病率下降，但在亚裔/太平洋岛民中则保持稳定；在所有这些种族/民族中，<50 岁年龄组的发病率基本稳定，但在老年组中则呈下降趋势。非西班牙裔白人中宫颈癌 SCC 和 AC 的远处转移阶段发病率在几个年龄组中增加，但在非白人中则基本稳定。AC 的发病率呈上升或稳定趋势，而 SCC 的早期下降趋势在几个亚群中有所减弱，这突出表明，需要加强努力扭转上升趋势，进一步降低美国宫颈癌的负担。
