Department of Ob-Gyn, Lyndon B. Johnson Tropical Medical Center, Faga'alu, American Samoa.
Department of Ob-Gyn, John A. Burns School of Medicine, University of Hawaii, Honolulu, HI, USA.
Int J Gynaecol Obstet. 2021 May;153(2):330-334. doi: 10.1002/ijgo.13130. Epub 2020 Apr 27.
To assess the contemporary incidence of cancers using American Samoa as a learning set for insights into similar populations.
A retrospective observational analysis of de-identified data held in public-access databases (2004-2014) and data on uterine cancer from a hospital, both in American Samoa (2015-2016).
There were 341 new cases of cancer in 2004-2014 (111 per 100 000 women/year), including breast (20.2%), uterine (19.4%), and cervical (5.0%); and 287 in 2011-2015 (103 per 100 000 women/year), including uterine (24.0%), breast (18.5%), and cervical (5.2%). Uterine cancer increased from 21.4 to 60.3 per 100 000 women/year, becoming the most common cancer in American Samoa. In 2011-2015, the incidence-rate ratio of uterine cancer to other cancers in American Samoa was 1.3-, 3.8-, 4.6-, 7.7-, and 23-fold higher than breast, colon, cervical, ovarian, and lung cancer, respectively. Among the most recent cases (n=33), median age was 55 years (10 [30.3%] <50 years), median BMI was 38.2; and 11 (33.3%) cases had grade 3 histology.
The pattern of cancers in American Samoa differs from that in the US mainland. The findings reflect significant changes in cancer incidence. Cancer control programs should evaluate the potential of uterine screening in accordance with their community's needs and characteristics.
利用美属萨摩亚作为学习范例,评估癌症的当代发病率,以深入了解类似人群的情况。
对公共访问数据库(2004-2014 年)中保存的已去识别数据以及美属萨摩亚一家医院的子宫癌数据(2015-2016 年)进行回顾性观察分析。
2004-2014 年期间有 341 例新癌症病例(每 10 万名女性中有 111 例/年),包括乳腺癌(20.2%)、子宫癌(19.4%)和宫颈癌(5.0%);2011-2015 年期间有 287 例新癌症病例(每 10 万名女性中有 103 例/年),包括子宫癌(24.0%)、乳腺癌(18.5%)和宫颈癌(5.2%)。子宫癌的发病率从每 10 万名女性 21.4 例增加到 60.3 例/年,成为美属萨摩亚最常见的癌症。2011-2015 年,美属萨摩亚子宫癌与其他癌症的发病率比值分别为乳腺癌的 1.3 倍、结肠癌的 3.8 倍、宫颈癌的 4.6 倍、卵巢癌的 7.7 倍和肺癌的 23 倍。在最近的病例中(n=33),中位年龄为 55 岁(10 例[30.3%]<50 岁),中位 BMI 为 38.2;11 例(33.3%)为 3 级组织学。
美属萨摩亚的癌症模式与美国本土不同。这些发现反映了癌症发病率的显著变化。癌症控制计划应根据其社区的需求和特点,评估子宫筛查的潜力。