Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
Arch Iran Med. 2020 Jul 1;23(7):434-444. doi: 10.34172/aim.2020.40.
The present study aims to assess the incidence and mortality rates of gynecological cancers and their changes from 1990 to 2016 at national and subnational levels in Iran.
Annual estimates of incidence and mortality for gynecological cancers from 1990 to 2016 at national and subnational levels were generated as part of a larger project entitled National and Subnational Burden of Diseases, Injuries, and Risk Factors (NASBOD). After the precise processing of data extracted from the Iran Cancer Registry, annual age-standardized incidence and mortality rates were calculated for each cancer, province, year and age group during the period of the study.
In 2016, gynecological cancers constituted 8.0% of new cancer cases among women of all ages compared to 3.7% of new cases of cancer among women in 1990. The incidence rate of gynecological cancers has increased from 2.5 (0.9-5.6) per 100000 women in 1990 to 12.3 (9.3-15.7) per 100000 women in 2016, and the most common gynecological cancer has changed from cervical cancer in 1990 to corpus uteri cancer in 2016. Age-standardized incidence rates of ovarian, corpus uteri and vulvovaginal cancers increased from 1.3 (0.5-2.4), 1.7 (0.6-3.0), and 0.3 (0.0-0.7) in 1990 to 4.4 (3.6-5.2), 9.9 (6.8-13.4), and 0.6 (0.2-1.0) in 2016, respectively, showing a 3.3, 5.8 and 1.7-fold increase during this period. Age-standardized incidence rate of cervical cancer was 2.4 (1.7-3.3) cases per 100000 women in 2016 and did not differ significantly from the beginning of the study. An overall reduction was seen in national mortality to incidence ratios (MIR) from 2000 to 2015.
The incidence rates of all gynecological cancers in different provinces have shown a converging trend that could indicate that attempts toward health equality have been effective. The declining trend of MIR could be interpreted as advancements in detection of cancer in its early stages and also improvements in treatments, in turn reflecting improvements in access to and quality of care.
本研究旨在评估 1990 年至 2016 年期间伊朗国家和次国家一级妇科癌症的发病率和死亡率及其变化。
作为题为“国家和次国家疾病、伤害和危险因素负担（NASBOD）”的更大项目的一部分，生成了 1990 年至 2016 年国家和次国家一级妇科癌症的发病率和死亡率的年度估计值。在从伊朗癌症登记处提取的数据进行精确处理后，计算了研究期间每个癌症、省份、年份和年龄组的年度年龄标准化发病率和死亡率。
2016 年，妇科癌症占所有年龄段女性新发癌症病例的 8.0%，而 1990 年女性新发癌症病例的 3.7%。妇科癌症的发病率从 1990 年的每 100000 名妇女 2.5（0.9-5.6）例上升到 2016 年的每 100000 名妇女 12.3（9.3-15.7）例，最常见的妇科癌症也从 1990 年的宫颈癌变为 2016 年的子宫体癌。卵巢癌、子宫体癌和外阴阴道癌的年龄标准化发病率从 1990 年的 1.3（0.5-2.4）、1.7（0.6-3.0）和 0.3（0.0-0.7）分别上升至 2016 年的 4.4（3.6-5.2）、9.9（6.8-13.4）和 0.6（0.2-1.0），分别增长了 3.3、5.8 和 1.7 倍。2016 年，宫颈癌的年龄标准化发病率为每 100000 名妇女 2.4（1.7-3.3）例，与研究开始时相比没有显著差异。2000 年至 2015 年，全国死亡率与发病率的比值（MIR）总体下降。
不同省份的所有妇科癌症的发病率都呈收敛趋势，这表明在实现健康平等方面的努力是有效的。MIR 的下降趋势可以解释为癌症早期检测的进步，以及治疗的改进，这反过来又反映了获得和护理质量的提高。
