Reddy Megan, Tian Chunqiao, Liao Chen-I, Winkler Stuart, Johnson Caitlin R, Kapp Daniel S, Darcy Kathleen, Chan John K
California Pacific Medical Center, 795 El Camino Real, San Francisco, CA 94109, USA.
Gynecologic Cancer Center of Excellence, Department of Gynecologic Surgery and Obstetrics, Uniformed Services University of the Health Sciences, Walter Reed National Military Medical Center, Bethesda, MD, USA; The Henry M. Jackson Foundation for the Advancement of Military Medicine Inc., Bethesda, MD, USA.
Gynecol Oncol. 2024 Feb;181:118-124. doi: 10.1016/j.ygyno.2023.12.015. Epub 2023 Dec 27.
To evaluate patterns and trends of uterine cancer among Hispanic subgroups.
The United States Cancer Statistics (USCS), National Cancer Database (NCDB), and World Population Review were used to obtain data on incidence, demographic characteristics, and cancer histology. Joinpoint regression program was used for statistical analysis.
Based on 2001-2017 USCS data, the overall incidence of uterine cancer was 27.46 vs. 23.29/100,000 in Hispanics vs. non-Hispanic Whites. There was an over 2-fold higher annual increase in the incidence in Hispanics (1.94%; p < 0.001) vs. Whites (0.85%; p < 0.001), particularly in local stage disease. There was an increase in grade 1 endometrioid carcinoma (1.48%; p < 0.001 vs. -0.52%; p = 0.1) and aggressive histologic subtypes (4.04% p = 0.000 vs. 2.53% p = 0.000) in Hispanics vs. Whites. Using the NCDB (2004-2015), we analyzed 17,351 Hispanics by subgroup (Mexican, South/Central American, Puerto Rican, Cuban, and Dominican). Over the 12 years, there was an increase in the proportion of uterine cancer diagnoses in all Hispanics (5.2% to 11.0%; p < 0.0001). Dominican patients experienced the largest increase in diagnosis (2.6% to 14.9%; p < 0.0001), the highest proportion of advanced disease at 28.0% (p < 0.0001), and the highest incidence of non-endometrioid histologies at 37.1% (p < 0.0001). World Population Review 2023 revealed the highest female obesity rates in Puerto Rico (51.4%), the Dominican Republic (34.1%), and Mexico (32.8%).
Uterine cancer incidence is increased in Hispanics, with the largest increase in Dominican women with more advanced stages and high-risk histologic subtypes. The impact of obesity on cancer risk, especially in Puerto Ricans, Dominicans, and Mexicans, warrants further investigation.
评估西班牙裔亚组中子宫癌的发病模式和趋势。
使用美国癌症统计数据(USCS)、国家癌症数据库(NCDB)和世界人口评论来获取发病率、人口统计学特征和癌症组织学数据。采用Joinpoint回归程序进行统计分析。
根据2001 - 2017年的USCS数据,西班牙裔子宫癌的总体发病率为27.46/10万,而非西班牙裔白人的发病率为23.29/10万。西班牙裔的发病率年增长率(1.94%;p < 0.001)是非西班牙裔白人(0.85%;p < 0.001)的两倍多,尤其是在局部阶段疾病中。西班牙裔中1级子宫内膜样癌(1.48%;p < 0.001 vs. -0.52%;p = 0.1)和侵袭性组织学亚型(4.04% p = 0.000 vs. 2.53% p = 0.000)的发病率有所增加。使用NCDB(2004 - 2015年),我们按亚组(墨西哥、南美洲/中美洲、波多黎各、古巴和多米尼加)分析了17351名西班牙裔。在这12年中,所有西班牙裔子宫癌诊断比例有所增加(5.2%至11.0%;p < 0.0001)。多米尼加患者的诊断增加幅度最大(2.6%至14.9%;p < 0.0001),晚期疾病比例最高,为28.0%(p < 0.0001),非子宫内膜样组织学发病率最高,为37.1%(p < 0.0001)。《2023年世界人口评论》显示,波多黎各(51.4%)、多米尼加共和国(34.1%)和墨西哥(32.8%)的女性肥胖率最高。
西班牙裔子宫癌发病率有所上升,多米尼加女性的增幅最大,且疾病分期更晚,组织学亚型为高危型。肥胖对癌症风险的影响,尤其是在波多黎各人、多米尼加人和墨西哥人中,值得进一步研究。