Trends in gynecologic cancer among elderly women in Denmark, 1980–2012

ABSTRACT Background The aim of this analysis was to describe trends in incidence, mortality, prevalence, and survival in Danish women with gynecologic cancer from 1980–2012 comparing women aged 70 years or more with younger women. Material and methods Gynecologic cancers included were ICD-10 codes C53 (cancer of the cervix uteri), C54 (corpus uteri cancer), C56 (ovarian cancer) and C57 (Fallopian tube cancer). Data derived from the NORDCAN database with comparable data on cancer incidence, mortality, prevalence and relative survival in the Nordic countries, where the Danish data are delivered from the Danish Cancer Registry and the Danish Cause of Death Registry with follow-up for death or emigration until the end of 2013. Results For cervical cancer the incidence decreased among women aged less than 70 years and remained stable among the elderly. The mortality rates were clearly separated by age groups with a 2–3 fold higher mortality rate among 70 + years-old than younger women. The mortality rates, however, decreased in all age groups from 1980–2012. For ovarian and Fallopian tube cancers the incidence was almost constant, whereas the average annual number of deaths decreased over time from 466 in 1980 to 396 in 2012. The mortality rates were clearly separated by age groups with mortality rates 3–4 times higher among the elderly. The mortality rate decreased among women less than 70 years during the entire period. The average annual number of newly diagnosed corpus uteri cancer increased from 631 in 1980 to 773 in 2012. The mortality rates were clearly separated by age groups with much higher mortality rates among the 70+ years-old as compared with younger women. Overall the mortality rates decreased from 1980 to 2012. Conclusion In gynecologic cancer both mortality rates and survival are age-dependent with a significantly shorter survival in the group of elderly.

[1]  S. Kjaer,et al.  Ovarian cancer incidence and mortality in denmark, 1943‐1982 , 1988, International journal of cancer.

[2]  Paul W Dickman,et al.  Regression models for relative survival , 2004, Statistics in medicine.

[3]  K. Frederiksen,et al.  Cervical cancer incidence in Denmark over six decades (1943–2002) , 2006, Acta obstetricia et gynecologica Scandinavica.

[4]  R. Cress,et al.  Declining trends of epithelial ovarian cancer in California. , 2008, Gynecologic oncology.

[5]  B. Monk,et al.  Phase III trial of four cisplatin-containing doublet combinations in stage IVB, recurrent, or persistent cervical carcinoma: a Gynecologic Oncology Group study. , 2009, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[6]  J. Hallas,et al.  Significance of age and comorbidity on treatment modality, treatment adherence, and prognosis in elderly ovarian cancer patients. , 2012, Gynecologic oncology.

[7]  V. Beral,et al.  Menopausal hormone use and ovarian cancer risk: individual participant meta-analysis of 52 epidemiological studies , 2015, The Lancet.

[8]  E. Miyagi,et al.  Radiation Therapy for Very Elderly Patients Aged 80 Years and Older With Squamous Cell Carcinoma of the Uterine Cervix , 2017, American journal of clinical oncology.

[9]  Michael W Sill,et al.  Improved survival with bevacizumab in advanced cervical cancer. , 2014, The New England journal of medicine.

[10]  B. Ottesen,et al.  Centralized treatment of advanced stages of ovarian cancer improves survival: a nationwide Danish survey , 2010, Acta obstetricia et gynecologica Scandinavica.

[11]  T. Bauknecht,et al.  A randomized clinical trial of cisplatin/paclitaxel versus carboplatin/paclitaxel as first-line treatment of ovarian cancer. , 2003, Journal of the National Cancer Institute.

[12]  Nicolas Wentzensen,et al.  Metabolic Syndrome and Risk of Endometrial Cancer in the United States: A Study in the SEER–Medicare Linked Database , 2015, Cancer Epidemiology, Biomarkers & Prevention.

[13]  S. Alam,et al.  The Cigarette Smoke Carcinogen Benzo[a]pyrene Enhances Human Papillomavirus Synthesis , 2007, Journal of Virology.

[14]  K. Christensen,et al.  Trends in cancer in the elderly population in Denmark, 1980–2012 , 2016, Acta oncologica.

[15]  K. Scher,et al.  Under-representation of older adults in cancer registration trials: known problem, little progress. , 2012, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[16]  A. Mitsuhashi,et al.  Daily Low-Dose Cisplatin-Based Concurrent Chemoradiotherapy for the Treatment of Cervical Cancer in Patients 70 Years or Older , 2015, International Journal of Gynecologic Cancer.

[17]  T. Whelan,et al.  Adjuvant external beam radiotherapy in the treatment of endometrial cancer (MRC ASTEC and NCIC CTG EN.5 randomised trials): pooled trial results, systematic review, and meta-analysis , 2009, The Lancet.

[18]  E. Partridge,et al.  Cyclophosphamide and cisplatin compared with paclitaxel and cisplatin in patients with stage III and stage IV ovarian cancer , 1996, New England Journal of Medicine.

[19]  U. Menon,et al.  Ovarian cancer screening—Current status, future directions☆ , 2014, Gynecologic oncology.

[20]  M. Johnston,et al.  Concurrent cisplatin-based chemotherapy plus radiotherapy for cervical cancer: a meta-analysis. , 2004, Clinical oncology (Royal College of Radiologists (Great Britain)).

[21]  Paul Symonds,et al.  Survival and recurrence after concomitant chemotherapy and radiotherapy for cancer of the uterine cervix: a systematic review and meta-analysis , 2001, The Lancet.