Department of Obstetrics and Gynecology, Skåne University Hospital Lund, Lund University, Sweden.
Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden.
Cancer Epidemiol Biomarkers Prev. 2022 Aug 2;31(8):1572-1581. doi: 10.1158/1055-9965.EPI-21-1323.
The aim was to investigate time trends for incidence and long-term net survival in the morphologic subtypes and stages of cervical cancer in Sweden during the period 1960 to 2014.
Women with invasive cervical cancer were identified through the Swedish Cancer Registry. Incidence and net survival were calculated according to morphology, age at diagnosis, and FIGO stage at diagnosis.
In total, 29,579 cases of invasive cervical cancer between 1960 and 2014 were included. The age-standardized incidence for squamous cell carcinoma (SCC) decreased until 2000; thereafter, the incidence rate stagnated, and a small increase was found in 2014. The incidence of adenocarcinoma continuously increased. The age-standardized 5-year net survival increased. However, decreasing net survival with increasing age was found. A higher stage at diagnosis showed a worse net survival. SCC and adenocarcinoma did not statistically differ as regards net survival in the last years of the study.
Age-standardized 5-year net survival improved between 1960 and 2014. A positive trend for short- and long-term net survival was seen for women ages 18 to 64 years but long-term net survival for women ≥75 years decreased. In this study, age and FIGO stage at diagnosis were found to be important prognostic factors in determining net survival. The morphologies, SCC, and adenocarcinoma did not statistically differ as regards net survival in the last years of the study.
This study demonstrates longitudinal data on cervical cancer in Sweden for over 50 years with sub analyses on morphology, age, and stage at diagnosis.
本研究旨在调查 1960 年至 2014 年期间瑞典宫颈癌形态学亚型和分期的发病率和长期净生存率的时间趋势。
通过瑞典癌症登记处确定患有浸润性宫颈癌的女性。根据形态、诊断时的年龄和诊断时的 FIGO 分期计算发病率和净生存率。
共纳入 1960 年至 2014 年间 29579 例浸润性宫颈癌病例。鳞状细胞癌（SCC）的年龄标准化发病率在 2000 年前下降；此后，发病率停滞不前，2014 年略有上升。腺癌的发病率持续上升。年龄标准化 5 年净生存率增加。然而，随着年龄的增长，净生存率下降。诊断时的较高分期显示出较差的净生存率。在研究的最后几年，SCC 和腺癌在净生存率方面没有统计学差异。
1960 年至 2014 年间，年龄标准化 5 年净生存率有所提高。18 至 64 岁女性的短期和长期净生存率呈上升趋势，但≥75 岁女性的长期净生存率下降。在这项研究中，诊断时的年龄和 FIGO 分期被发现是决定净生存率的重要预后因素。在研究的最后几年，形态、SCC 和腺癌在净生存率方面没有统计学差异。
本研究展示了瑞典超过 50 年的宫颈癌纵向数据，并对形态、年龄和诊断时的分期进行了亚分析。
