Objective The three major gynecologic cancers are cervical, endometrial, and ovarian cancer. This study aimed to describe the 19-year trends and survival rates in cervical, endometrial, and ovarian cancer in a Korean female population.Methods We searched the Korea Central Cancer Registry to identify patients with gynecologic cancer between 1999 and 2017. Age-standardized rates and annual percent changes were calculated. The relative survival rate (RSR) was reported by histology, age, and stage for each gynecological cancer.Results The total number of cervical, endometrial, primary peritoneal, ovarian epithelial, fallopian tube (POFT) cancer was 134,863, with the number of cases increasing every year: 6,077 in 1999 to 8,011 in 2017. The incidence of cervical cancer has decreased; however, that of POFT and endometrial cancer has increased. The 5-year RSR of cervical, POFT, and endometrial cancer was reported to be 80.8%, 61.4%, and 88.1%, respectively. In the case of cervical cancer, squamous cell carcinoma showed better survival than other histology (82.8% vs. 73.5%). Furthermore, in the case of endometrial cancer, endometrioid histology had substantially better 5-year RSR than the others (93.2% vs. 76.5%). Contrastingly, in the case of ovarian cancer, serous carcinoma had worse 5-year RSR than other types of histology.Conclusion The incidence rates for gynecologic cancers increased from 2005 to 2017, with an annual increase of 2.76 per year until 2017. Endometrial cancer had the highest RSR, while ovarian cancer had the lowest. Active cancer screening and the introduction of effective treatments might have contributed to the improved RSRs of gynecologic cancers.

The cervical microbiome is associated with cervical cancer risk, but how microbial diversity and functional profiles change in cervical cancer remains unclear. Herein, we investigated microbialcompositional and functional differences between a control group and a high-grade cervical intraepithelial neoplasia and cervical cancer (CIN2/3-CC) group. After retrospective collection of 92 cervical swab samples, we carried out 16S rRNA amplicon sequencing on 50 and 42 samples from the control and CIN2/3-CC groups, respectively. The EzBioCloud pipeline was applied to identify the genomic features associated with the groups using 16S rRNA data. A linear discriminant analysis effect size (LEfSe) was performed to assess the enrichment in the assigned taxonomic and functional profiles. We found a lower richness in the control group relative to the CIN2/3-CC group; however, the β-diversity tended to be similar between the groups. The LEfSe analysis showed that a phylum Sacchaaribacteria_TM7, 11 genera, and 21 species were more abundant in the CIN2/3-CC group and that one uncharacterized Gardnerella species was more abundant only in the control group. Further characterization of the functional pathways using EzBioCloud showed that the 4 KEGG orthologs (Phosphotransferase system [PTS] sucrose-specific IIA, IIB, IIC components and PTS cellubiose-specific IIC component) were involved in the KEGG pathway of starch and sucrose metabolism. The two pathways of folate biosynthesis and oxidative phosphorylation were more abundant in the CIN2/3-CC group. Further confirmation of these results in larger samples can help to elucidate the potential association between the cervical microbiome and cervical cancer. Cervical intraepithelial neoplasia (CIN) is a precancerous lesion in cervical epithelial cells, and is histologically divided into different grades 1. Infection with HPV is the most important causative factor for CIN or cervical cancer. Although HPV is a major risk factor for cervical precancerous lesions or cancer, the potential role of the cervicovaginal microbiome in cervical cancer via the elevation of pH also has been reported 2. In fact, the role of the cervicovaginal microbiome in HPV infection has already been established, which fact suggests a possible role in cervical cancer through potentiation of HPV infection 3. Interestingly, the action of the microbiota is a complex process, the scientific data on which remains sparse 4,5. The impact of the microbiome and its functions on cervical pathophysiology differ among individuals 6. There is increasing evidence that the cervical microbiome plays important roles in the carcinogenesis process of the uterine cervix; thus, it is being considered as a target for development of innovative therapeutic approaches 7,8. The cervical microbiome's importance lies in its provision of the metabolic pathways and enzymatic machinery that help to process essential vitamins, remove toxic compounds, defend against pathogens, strengthen the female genital-tract epithelium, and stimulate as well a...

ObjectivesDespite the possibility of early detection of cervical cancer, participation in screening programmes among young Koreans is low. We sought to identify associations between risk factors and participation in screening for cervical cancer among young Koreans.DesignNationwide cross-sectional study.SettingRepublic of Korea.Participants3734.Main outcome measuresThe Korea National Health and Nutrition Examination Survey (KNHANES V: 2010–2012) was used to evaluate factors associated with attendance for cervical cancer screening among women aged 15–39. After excluding those who were previously diagnosed with cervical cancer and those with incomplete responses to questionnaires, a total of 3734 subjects were eligible. Multi-dimensional covariates as potential predictors of cervical cancer screening were adjusted in multiple logistic regression analysis.ResultsThe participation rate for cervical cancer screening was 46% among women aged 40 or younger. The logistic analyses showed that age, education, total household income, smoking and job status among women aged 15–39 were associated with participation in cervical cancer screening (p<0.05). After age stratification, the associated factors differed by age groups. Moreover, a dose–response between participation in cervical cancer screening and high total household income in the 30–39 age group was seen.ConclusionsPredictive factors differed among young women (aged 15–29 vs 30–39). Thus, age-specific tailored interventions and policies are needed to increase the participation rate in screening for cervical cancer.

The yield of CE in carefully selected patients with obscure bleeding approximates 51%. There appear to be few complications, and patient satisfaction appears high. Cost analysis and further studies of clinical outcomes are required to elucidate appropriate indications for this device.