Department of Global Public Health and Primary Care, University of Bergen, 5020, Bergen, Norway.
Cancer Registry of Norway, Oslo, Norway.
BMC Womens Health. 2021 Mar 18;21(1):110. doi: 10.1186/s12905-021-01242-3.
We compared women with incident cervical cancer under the age of 30 with older women with regard to stage, morphology, screening history and cervical cancer mortality in a population-based cohort study.
We included data from the Cancer Registry of Norway. Incidence rates (per 100,000 women-years) were calculated and joinpoint regression was used to analyse trends. The Nelson-Aalen cumulative hazard function for risk of cervical cancer death during a 15-year follow-up was displayed. The hazard ratios (HRs) of cervical cancer mortality with 95% confidence intervals (CIs) were derived from Cox regression models.
The incidence of cervical cancer in women under the age of 30 has almost tripled since the 1950s, with the steepest increase during 1955-80 (with an annual percentage change (APC) of 7.1% (95%CI 4.4-9.8)) and also an increase after 2004 (3.8% (95%CI -1.3-9.2)). Out of 21,160 women with cervical cancer (1953-2013), 5.3% were younger than 30 years. A lower proportion of younger women were diagnosed at more advanced stages and a slightly higher proportion were diagnosed with adenocarcinoma and adenosquamous carcinoma comparing women above 30 years. The cumulative risk of cervical cancer death was lower for patients under the age of 30. However, the difference between the age groups decreased over time. The overall adjusted HR of cervical cancer mortality was 0.69 (95% CI 0.58-0.82) in women diagnosed under the age of 30 compared to older women.
There has been an increase in cervical cancer incidence in women under the age of 30. Cervical cancer in younger women was not more advanced at diagnosis compared to older women, and the cervical cancer mortality was lower.
我们在一项基于人群的队列研究中比较了年龄在 30 岁以下的宫颈癌新发病例女性与年龄较大的女性的分期、形态、筛查史和宫颈癌死亡率。
我们纳入了挪威癌症登记处的数据。计算了发病率（每 10 万名妇女年），并使用连接点回归分析了趋势。使用 Nelson-Aalen 累积危险函数显示了 15 年随访期间宫颈癌死亡的风险。使用 Cox 回归模型得出了宫颈癌死亡率的风险比（HR）及其 95%置信区间（CI）。
自 20 世纪 50 年代以来，30 岁以下女性宫颈癌的发病率几乎增加了两倍，1955-80 年期间增加最为陡峭（年百分比变化（APC）为 7.1%（95%CI 4.4-9.8%）），2004 年后也有所增加（3.8%（95%CI -1.3-9.2%））。在 21160 名宫颈癌患者（1953-2013 年）中，5.3%的患者年龄小于 30 岁。与年龄较大的女性相比，年轻女性的诊断分期较低，腺癌和腺鳞癌的比例略高。30 岁以下患者宫颈癌死亡的累积风险较低。然而，两组之间的差异随时间逐渐缩小。与年龄较大的女性相比，年龄在 30 岁以下的患者宫颈癌死亡率的总体调整 HR 为 0.69（95%CI 0.58-0.82）。
30 岁以下女性宫颈癌的发病率有所增加。与年龄较大的女性相比，年轻女性的宫颈癌诊断时分期并不更晚，且宫颈癌死亡率较低。
