Declining hysterectomy prevalence and the estimated impact on uterine cancer incidence in Scotland |
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| Institution: | 1. Usher Institute for Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, United Kingdom;2. Scottish Cancer Registry, NHS National Services Scotland, Gyle Square, 1 South Gyle Crescent, Edinburgh EH12 9EB, United Kingdom;3. Division of Cancer Sciences, Faculty of Biology, Medicine and Health, University of Manchester, United Kingdom;1. School of Population and Public Health, University of British Columbia, Vancouver, Canada;2. Population Oncology, BC Cancer, Vancouver, Canada;3. Community Health Sciences, University of Manitoba, Winnipeg, Canada;4. Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada;1. UF 1441 Registre Général des cancers de la Martinique, Pôle de Cancérologie Hématologie Urologie Pathologie, CHU de Martinique, 97200, Fort-de-France, Martinique;2. UF 3163, Unité de soutien méthodologique à la Recherche, Délégation de la Recherche et de l’innovation, CHU Martinique, 97200, Fort-de-France, Martinique;3. Pôle de Cancérologie Hématologie Urologie Pathologie, CHU de Martinique, 97200, Fort-de-France, Martinique;1. Department of Oncology and Department of Clinical and Experimental Medicine, Linköping University, Sandbäcksgatan 7, 582 25, Linköping, Sweden;2. Center for Primary Health Care Research, Lund University, Clinical Research Center, 202 13, Malmö, Sweden;3. Department of Family Medicine and Community Health, Icahn School of Medicine at Mount Sinai, 1425 Madison Avenue, Suite L5-40, New York, NY 10029, USA;1. Department of Hematology and Central Hematology Laboratory, Inselspital, Bern University Hospital, University of Bern, Switzerland;2. Department for BioMedical Research, University of Bern, Switzerland;3. Foundation National Institute for Cancer Epidemiology and Registration (NICER) c/o University of Zurich, Switzerland;4. Division of Hematology and Central Hematology Laboratory, Cantonal Hospital Lucerne, Switzerland;5. Divisions of Hematology, Department of Medicine, University Hospital Basel, Switzerland;6. Clinic of Medical Oncology and Hematology, City Hospital Triemli Zurich, Switzerland;7. Clinic of Oncology/Hematology, Cantonal Hospital Muensterlingen, Switzerland;8. Clinic of Oncology/Hematology, Cantonal Hospital Thun, Switzerland;9. Clinic of Hematology, Oncology Institute of Southern Switzerland, Switzerland;10. Unit of Cancer Survivorship, Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany |
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| Abstract: | AimThe prevalence of hysterectomy is decreasing worldwide. It is not clear whether changes in the population at risk (women with intact uteruses) have contributed to an increased uterine cancer incidence. This study aims to assess the effect of changing trends in hysterectomy prevalence on uterine cancer incidence in Scotland.MethodsThe population of women aged ≥25 years with intact uteri was estimated using the estimated hysterectomy prevalence in 1995 and the number of procedures performed in Scotland (1996–2015). Age-standardized uterine cancer incidence was estimated using uncorrected (total) or corrected (adjusted for hysterectomy prevalence) populations as denominators and the number of incident cancers as numerators. Annual percentage change in uterine cancer was estimated.ResultsHysterectomy prevalence fell from 13% to 10% between 1996–2000 and 2011–2015, with the most marked decline (from 20% to 6%) in the 50–54-year age group. After correction for hysterectomy prevalence, age-standardized incidence of uterine cancer increased by 20–22%. Annual percentage change in incidence of uterine cancer remained stable through the study period and was 2.2% (95%CI 1.8–2.7) and 2.1% (95%CI 1.7–2.6) for uncorrected and corrected estimates, respectively.ConclusionUterine cancer incidence in Scotland corrected for hysterectomy prevalence is higher than estimates using a total female population as denominator. The annual percentage increase in uterine cancer incidence was stable in both uncorrected and corrected populations despite a declining hysterectomy prevalence. The rise in uterine cancer incidence may thus be driven by other factors, including an ageing population, changing reproductive choices, and obesity. |
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| Keywords: | Endometrial Womb Uterine Cancer Hysterectomy |
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