Faculty of Medicine Nis, University of Nis, 18000 Nis, Serbia.
Institute for Public Health Nis, 18000 Nis, Serbia.
Medicina (Kaunas). 2022 Feb 17;58(2):306. doi: 10.3390/medicina58020306.
There were 1,335,503 newly diagnosed cases of the most common gynecological cancers in women (cervical, uterine and ovarian cancer) worldwide in 2020. The main objective of this paper was to assess temporal changes in incidence rates of the most common gynecological cancers and to determine the age group with the greatest increase in incidence in the Serbian female population in the period 2003-2018. Trends and annual percentage change (APC) of the incidence rate with corresponding 95% confidence intervals (CI) were calculated by Joinpoint regression analysis. The trend was considered to be significantly increasing (positive change) or decreasing (negative change) when the -value was below 0.05 ( < 0.05). The total number of newly registered cancer cases from 2003 to 2018 was 35,799. There was a significant increase of age standardized rate (ASR) for all cancer incidences in women from 2012 to 2018 with APC 6.9% (95% CI from 0.9 to 13.3, = 0.028) and for uterine cancer during the 2014-2018 period with APC of 16.8% (95% CI: from 4.0 to 31.1, = 0.014), as well as for ovarian cancer incidence in the 2012-2018 period with APC of 12.1% (95% CI: from 6.7 to 17.8, < 0.001). A non-significant decrease of ASRs of incidence for cervical cancer was determined from 2003 to 2015 with APC of -0.22% (95% CI: from -3.4 to 3.1, = 0.887) and a non-significant increase of ASRs incidence from 2015 to 2018 with APC of 14.21% (95% CI: from -13.3 to 50.5, = 0.311). The most common gynecological cancers were present in all age groups and only ovarian cancer was registered in the youngest age group (0-4 years). Cervical cancer showed a typical increase after the age of 30, with peak incidence in women aged 40-44 and 65-69 years. The increased incidence trend regarding age for cervical cancer (y = 1.3966x + 0.3765, R = 0.3395), uterine cancer (y = 1.7963x - 5.4688, R = 0.5063) and ovarian cancer (y = 1.0791x - 0.8245, R = 0.5317) is statistically significant. Based on our presented results, a significant increase of incidence trend for the most common gynecological cancers in the Serbian female population from 2012 to 2018 was determined. There has been a significant increase in the incidence of uterine cancer from 2014 up to 2018, as well as for ovarian cancer from 2012 up to 2018, while cervical cancer showed a non-significant decrease of incidence trend from 2003 until 2015 and then a non-significant increase. In women below 20 years of age, ovarian cancer was significantly more prevalent, while cervical cancer was significantly more prevalent in the age groups 20-39 and 40-59 years. In the age group of 60-79, uterine cancer had a significantly higher incidence than the other two cancers. Measures of primary prevention, such as vaccination of children against and screening measures of secondary prevention, for the female population aged 25 to 64 years of age are needed, as well as educating females about healthy lifestyles via media and social networks to help prevent the most common gynecological cancers.
2020 年,全球有 1335503 例新诊断的最常见妇科癌症(宫颈癌、子宫癌和卵巢癌)。本文的主要目的是评估最常见妇科癌症发病率的时间变化,并确定塞尔维亚女性人群中发病率增长最大的年龄组。通过 Joinpoint 回归分析计算发病率的趋势和年度百分比变化(APC),并伴有相应的 95%置信区间(CI)。当 - 值低于 0.05( < 0.05)时,认为趋势呈显著增加(阳性变化)或减少(阴性变化)。从 2003 年到 2018 年,新登记的癌症病例总数为 35799 例。在 2012 年至 2018 年期间,所有女性癌症发病率的年龄标准化率(ASR)均显著增加,APC 为 6.9%(95%CI:0.9 至 13.3, = 0.028),子宫癌发病率在 2014 年至 2018 年期间增加了 16.8%(95%CI:4.0 至 31.1, = 0.014),卵巢癌发病率在 2012 年至 2018 年期间增加了 12.1%(95%CI:6.7 至 17.8, < 0.001)。从 2003 年至 2015 年,宫颈癌的 ASR 呈非显著下降,APC 为-0.22%(95%CI:-3.4 至 3.1, = 0.887),从 2015 年至 2018 年,ASR 呈非显著增加,APC 为 14.21%(95%CI:-13.3 至 50.5, = 0.311)。最常见的妇科癌症存在于所有年龄组,只有卵巢癌存在于最年轻的年龄组(0-4 岁)。宫颈癌在 30 岁以后呈现典型增加,发病率在 40-44 岁和 65-69 岁的女性中达到峰值。宫颈癌(y = 1.3966x + 0.3765,R = 0.3395)、子宫癌(y = 1.7963x - 5.4688,R = 0.5063)和卵巢癌(y = 1.0791x - 0.8245,R = 0.5317)的发病率随年龄增加的趋势具有统计学意义。基于我们提出的结果,确定了 2012 年至 2018 年期间塞尔维亚女性人群中最常见妇科癌症发病率的显著增加趋势。从 2014 年到 2018 年,子宫癌的发病率显著增加,从 2012 年到 2018 年,卵巢癌的发病率也显著增加,而宫颈癌的发病率从 2003 年到 2015 年呈非显著下降,然后呈非显著增加。在 20 岁以下的女性中,卵巢癌的发病率明显更高,而宫颈癌在 20-39 岁和 40-59 岁年龄组中明显更常见。在 60-79 岁年龄组中,子宫癌的发病率明显高于其他两种癌症。需要为 25 至 64 岁的女性人口采取初级预防措施,如儿童接种疫苗和二级预防筛查措施,并通过媒体和社交网络向女性宣传健康的生活方式,以帮助预防最常见的妇科癌症。