Department of Obstetrics and Gynecology, College of Medicine, National Taiwan University, Taipei, Taiwan, ROC.
Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan, ROC.
Sci Rep. 2023 Jan 19;13(1):1019. doi: 10.1038/s41598-022-21669-4.
To evaluate the uterine corpus cancer incidence rates, age-specific trends, and birth cohort patterns by different histologic types. We conducted a retrospective cohort study of uterine cancer patients (n = 28,769) of all ages from the National Cancer Registry of Taiwan between 1998 and 2017. We estimated the incidence trends, average annual percent changes (AAPCs), and cancer-specific survival (CSS) rate for the two main subtypes (endometrioid and nonendometrioid) of uterine cancer in Taiwan. During the study period, uterine corpus cancer incidence rates increased over time from 5.3 to 15.21 per 100,000 women. Incidence trends for endometrioid carcinoma increased in all age groups (positive AAPCs > 5% for each age group), and the rise was steeper among women aged 50 years and younger. For nonendometrioid carcinomas, incidence rates increased among women over 50 years. The CSS rate improved among women with stage I (hazard ratio [HR] 0.63, 95% confidence interval [CI] 0.49-0.81) and stage III (HR 0.72, 95% CI 0.58-0.90) endometrioid carcinomas after 2013 compared with those during 2009-2012. However, the CSS rate remained unchanged for nonendometrioid carcinomas. Age, diagnostic period, stage and histologic types were significant factors associated with the 5-year CSS rate. We found that the incidences of both endometrioid and nonendometrioid carcinomas continued to increase among contemporary birth cohorts. Etiologic research is needed to explain the causes of these trends.
为评估不同组织学类型的子宫体癌发病率、年龄别趋势和出生队列模式。我们对 1998 年至 2017 年间所有年龄段的台湾国家癌症登记处的 28769 例子宫癌患者进行了回顾性队列研究。我们估计了台湾两种主要子类型（子宫内膜样和非子宫内膜样）的子宫癌的发病率趋势、平均年百分比变化（AAPC）和癌症特异性生存率（CSS）。在研究期间，子宫体癌的发病率随着时间的推移从每 100,000 名女性 5.3 例增加到 15.21 例。子宫内膜样癌的发病趋势在所有年龄组中均呈上升趋势（每个年龄组的阳性 AAPC 均>5%），50 岁及以下女性的上升幅度更大。对于非子宫内膜样癌，50 岁以上女性的发病率增加。与 2009-2012 年相比，2013 年后，I 期（风险比[HR]0.63，95%置信区间[CI]0.49-0.81）和 III 期（HR 0.72，95%CI 0.58-0.90）子宫内膜样癌患者的 CSS 率有所提高。然而，非子宫内膜样癌的 CSS 率保持不变。年龄、诊断期、分期和组织学类型是与 5 年 CSS 率相关的重要因素。我们发现，当代出生队列中子宫内膜样癌和非子宫内膜样癌的发病率都在继续上升。需要进行病因学研究来解释这些趋势的原因。
