A Population-based Study of Invasive Cervical Cancer Patients in Beijing

Abstract

Background:In recent years, the incidence of cervical cancer has been rising, particularly in young adults, as the second most common gynecological cancer in China. The aim of this study was to explore the incidence change and the epidemiological characteristics of cervical cancer in Beijing over the past 16 years.Methods:All the cases of the study were limited to Beijing residents diagnosed with cervical cancer and registered in Beijing from January 1, 1993, to December 31, 2008. A total of 4100 patients with cervical cancer were obtained from the Statistics Database of Beijing Cancer Registry (BJCaR). According to the registered data, we retrospectively reviewed all original cases which we can acquired in reported hospital. Cervical situ cancer, cervical metastatic cancer, non-Beijing residents and repeatedly registered cases were excluded. Totally, 3641 registered cases were verified correctly. Meanwhile, we also collected the following data: Age, occupation, detected methods, histological type, and staging. The trends of incidence and mortality were analyzed by Joinpoint Regression Program 4.1.1.1 produced by National Cancer Institute (NCI, USA). The annual percent change (APC) was calculated using the Joinpoint regression model.Results:The crude rates of incidence and mortality were 10.4 and 1.0 per 100,000 women, respectively during 1993 to 2008. The average WHO age-standardized incidence rates were 11.5 per 100,000 women. There was a decrease in incidence annually by 8.0% (P = 0.3) during 1993–1996 and a rapid increase annually by 18.9% after 1999 (P < 0.01). The median age was 67 years in 1993, but the median age decreased to 45 years in 2008. The peak of the age-specific incidence curve was at 40 years in the most recent period (2005–2008), which was 25–30 years earlier than that in previous periods (1993–1996). In the 2224 cases, the numbers of patients with stage I, II, III and IV were 910 (40.9%), 601 (27%), 542 (24.4%), 171 (7.7%), respectively. The percentage of patients with stage I was 7.6% (13/171) in 1993–1996, but the percentage increased to 51.6% (643/1247) in 2005–2008 (P < 0.01). Otherwise the percentage of advanced stage (stage III–IV) during the same period was dropped down significantly from 52.0% (89/171) to 22.5% (280/1247) (P < 0.01). Unemployed and housewife ranked first accounting for 27.3% of the total (607/2224). Urban low-income people such as worker ranked the second accounting for 17.0% (377/2224), the third place was farmer accounting for 14.0% (312/2224). Only 381 (17.1%, 381/2224) women in 2224 were first detected cervical cancer by routine screenings. Company staff (36.5%, 139/381), professional and technical personnel (22.6%, 86/381), national official (22.0%, 84/381) occupied the top three (total 81.1%) in the 381 patients detected cervical cancer by screening.Conclusions:The cervical cancer incidence has showed a continuous rise in Beijing since 1999. Government-led mass screening should target the low socioeconomic population primarily. Meanwhile the government should en...

Comparison of Secular Trends in Cervical Cancer Mortality in China and the United States: An Age-Period-Cohort Analysis

“…Thus, when cervical cancer screening guidelines are developed in the future, risk factors affecting different socioeconomic populations should be considered. To better prevent and treat this disease, regular and effective free screening should be widely performed in the different regions of China [7]. …”

“…It has been estimated that approximately 530,000 women were newly diagnosed with cervical cancer in 2008 and more than 250,000 women die from cervical cancer each year worldwide [7,8]. Of the cases of cervical cancer identified worldwide, nearly 78% occurred in developing countries while developed countries accounted for only 4.4% of the total cases [9].…”

“…In the United States—the largest developed country in the world, approximately 12,360 cervical cancer cases and more than 4000 cervical cancer deaths were reported in 2014 [10]. As the world’s largest developing country, it has been estimated that nearly 100,000 cervical cancer cases, accounting for approximately 20% of total new cases globally, and nearly 30,000 women cervical cancer deaths occur in China each year [7]. Due to widespread implementation of cytology screening since its introduction in the 1960s, cervical cancer mortality rates have declined in the United States and China; however, declines in the United States have recently leveled off, and the mortality rate in China remains high in some impoverished areas including Gansu, Shanxi and Western China [7,11].…”

“…As the world’s largest developing country, it has been estimated that nearly 100,000 cervical cancer cases, accounting for approximately 20% of total new cases globally, and nearly 30,000 women cervical cancer deaths occur in China each year [7]. Due to widespread implementation of cytology screening since its introduction in the 1960s, cervical cancer mortality rates have declined in the United States and China; however, declines in the United States have recently leveled off, and the mortality rate in China remains high in some impoverished areas including Gansu, Shanxi and Western China [7,11]. Overall, the specific reasons for the aforementioned trends in cervical cancer mortality rates remain unclear, and there is an urgent need for more research to be conducted to explore the underlying causes of these trends.…”

Crk-like adapter protein is overexpressed in cervical carcinoma, facilitates proliferation, invasion and chemoresistance, and regulates Src and Akt signaling

“…Cervical cancer is one of most common gynecological malignancies (1) and the incidence is increasing in China, where the age-specific incidence rate increased from 8.76 to 23.1 cases per 100,000 individuals between 1993 and 2008 (2). Despite the treatment of cervical cancer patients with surgery and adjuvant therapy, such as radiotherapy and chemotherapy, the effectiveness of treatment has not improved significantly over the past decades (3,4).…”