Geographic and temporal variations in cancer of the corpus uteri: Incidence and mortality in pre- and postmenopausal women in Europe

Authors

  • Freddie Bray,

    Corresponding author
    1. Non-communicable Disease Epidemiology Group, International Agency for Research on Cancer, Lyon, France
    2. Descriptive Epidemiology Group, London School of Hygiene and Tropical Medicine, London, United Kingdom
    3. Division of Clinical and Registry-based Research, Comprehensive Cancer Centre West, Leiden, the Netherlands
    • Division of Clinical and Registry-based Research, Cancer Registry of Norway, Institute of Population-based Cancer Research, Montebello, N-0310 Oslo, Norway
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    • Fax: +47-22-45-13-70.

  • Anja H. Loos,

    1. Non-communicable Disease Epidemiology Group, International Agency for Research on Cancer, Lyon, France
    2. Descriptive Epidemiology Group, London School of Hygiene and Tropical Medicine, London, United Kingdom
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  • Mariet Oostindier,

    1. Descriptive Epidemiology Group, London School of Hygiene and Tropical Medicine, London, United Kingdom
    2. Division of Clinical and Registry-based Research, Comprehensive Cancer Centre West, Leiden, the Netherlands
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  • Elisabete Weiderpass

    1. Descriptive Epidemiology Group, London School of Hygiene and Tropical Medicine, London, United Kingdom
    2. Division of Aetiological Research, Cancer Registry of Norway, Oslo, Norway
    3. Finnish Cancer Registry, Helsinki, Finland
    4. Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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  • The following European cancer registries (director in parentheses) are participating investigators in the Comprehensive Cancer Monitoring Programme in Europe, having contributed their data as well as their expertise in commenting on the final manuscript: Czech National Cancer Registry, Prague (Dr M. Jechová); Danish Cancer Society, Copenhagen (Dr H.H. Storm); Estonian Cancer Registry, Tallinn (Dr T. Aareleid); Finnish Cancer Registry, Helsinki (Dr T. Hakulinen); Registre Bas Rhinois des Cancers, Strasbourg (Dr M. Velten); Registre Général des Tumeurs du Calvados, Caen (Dr J. Macé-Lesech); Registre des Tumeurs du Doubs, Besançon (Dr A. Danzon); Registre du Cancer de l'Isère, Meylan (Dr F. Ménégoz); Registre du Cancer de la Somme, Amiens (Ms N. Raverdy); Registre des Cancers du Tarn, Albi (Dr M. Sauvage); Saarland Cancer Registry, Saarbrücken (Mr H. Ziegler); Icelandic Cancer Registry, Reykjavik (Dr L. Tryggvadottir); Registro Tumori Toscano, Florence (Dr E. Paci); Registro Tumori Lombardia (Provincia di Varese), Milan (Dr P. Crosignani); Registro Tumori della Provincia di Parma, Parma (Dr V. De Lisi); Registro Tumori della Provincia di Ragusa, Ragusa (Dr R. Tumino); Piedmont Cancer Registry, Turin (Dr R. Zanetti); Eindhoven Cancer Registry, Eindhoven (Dr J.W. Coebergh); Maastricht Cancer Registry, Maastricht (Dr M. Dirx); Cancer Registry of Norway, Oslo (Dr F. Langmark); Cracow Cancer Registry, Cracow (Dr J.a Rachtan); Lower Silesian Cancer Registry, Wroclaw (Mr J. Blaszczyk); Warsaw Cancer Registry, Warsaw (Dr M. Zwierko); National Cancer Registry of Slovak Republic, Bratislava (Dr I. Plesko); Cancer Registry of Slovenia, Ljubljana (Dr M. Primic-Zakelj); Tarragona Cancer Registry, Reus (Dr J. Galceran); Registro de Cáncer de Granada, Granada (Dr C. Martínez Garcia); Registro de Cáncer de Murcia, Murcia (Dr C. Navarro Sánchez); Registro de Cáncer de Navarra, Pamplona (Dr E. Ardanaz Aicua); Zaragoza Cancer Registry, Zaragoza (Dr C. Martos Jimenez); Swedish Cancer Registry, Stockholm (Dr L. Barlow); Krebsregister Basel-Stadt und Basel-Land, Basle (Dr G. Jundt); Registre Genevois des Tumeurs, Geneva (Dr C. Bouchardy); Registre Neuchâtelois des Tumeurs, Neuchâtel (Dr F. Levi); Krebsregister St Gallen Appenzell, St Gallen (Dr T. Fisch); Registre Vaudois des Tumeurs, Lausanne (Dr F. Levi); Kantonalzürcherisches Krebsregister, Zürich (Dr N. Probst); National Cancer Intelligence Centre, London (Dr M. Quinn); Scottish Cancer Registry, Edinburgh (Dr D. Brewster).

Abstract

Corpus uteri cancer is the fourth most common neoplasm in women in Europe and the tenth most common cause of cancer death. We examined geographic and temporal variations in corpus uteri cancer incidence and mortality rates in the age groups 25–49 and 50–74 in 22 European countries. The disease is considerably less common in premenopausal women, with incidence and mortality rates decreasing throughout Europe and mortality declines more marked in western and southern European countries. Incidence rates among postmenopausal women are highest in the Czech Republic, Slovakia, Sweden and Slovenia and lowest in France and the United Kingdom. Increasing incidence trends in this age group are observed in the Nordic countries (except Denmark) and in the United Kingdom. Some increases are also seen in eastern (Slovakia) and southern Europe (Spain and Slovenia), while relatively stable or modestly decreasing trends are observed in Italy and most western European countries. Postmenopausal mortality rates are systematically higher in eastern Europe, with death rates in the Ukraine, Latvia, Czech Republic, Russia and Belarus 2–3 times those seen in western Europe. Declining mortality trends are seen in most populations, though in certain Eastern European countries, the declines began rather recently, during the 1980s. In Belarus and Russia, recent postmenopausal death rates are stable or increasing. The rates are adjusted for misclassification of uterine cancer deaths but remain unadjusted for hysterectomy, and where there is an apparent levelling off of incidence or mortality rates recently, rising prevalence of hysterectomy cannot be discounted as an explanation. However, the trends by age group can be viewed in light of several established risk factors for endometrial cancer that are highly prevalent and most likely changing with time. These are discussed, as are the prospects for preventing the disease. © 2005 Wiley-Liss, Inc.

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