[1]Shanghai Municipal Center for Disease Control and Prevention, Department of Elderly Health,Shanghai,China
[2]Shanghai Municipal Center for Disease Control and Prevention,Shanghai,China
[3]Vanderbilt Ingram Cancer Center, Division of Epidemiology,Nashville,United States
[4]Shanghai Municipal Center for Disease Control and Prevention, Department of Noncommunicable Disease Surveillance,Shanghai,China
[5]Shanghai Municipal Center for Disease Control and Prevention, Department of Vital Statistics,Shanghai,China
[6]Shanghai Municipal Center for Disease Control and Prevention, Institute of Non-Communicable Disease and Injury,Shanghai,China
[7]Shanghai Jiaotong University, Department of Epidemiology,Shanghai,China
[8]Medical Center of Fudan University, Department of Epidemiology,Shanghai,China
[9]Renji Hospital, Department of Epidemiology,Shanghai,China
[10]Vanderbilt Ingram Cancer Center, Department of Medicine,Nashville,United States
[11]Vanderbilt University School of Medicine, Department of Medicine,Nashville,United States
Aim Appraisal of cancer trends is essential for future cancer control, but relevant studies in China are scarce due to a lack of long-term data. With 40-years of cancer registry data, we sought to evaluate secular time trends in incidence and mortality of gynaecological cancers in an urban Chinese population. Materials and methods Data on incidence and mortality of invasive cervical, uterine and ovarian cancer were collected by the Shanghai Cancer Registry. Age-standardised incidence and mortality rates were calculated for women aged 20-84 in urban Shanghai between 1973 and 2012. Age-period-cohort Poisson regression models were used to evaluate age, period and cohort effects. Overall linear trends, interpreted as the estimated annual percentage change (EAPC), were derived from the net drift in age-drift models. Results Overall, cervical cancer incidence and mortality substantially decreased (EAPC = -4.5% and -5.5%, respectively); however, an upward trend was apparent among younger women (age <60). Uterine cancer incidence increased slightly (EAPC = 1.8%), while mortality decreased over time (EAPC = -2.4%). Ovarian cancer incidence and mortality both increased, although the increase in incidence (EAPC = 1.8%) was larger than mortality (EAPC = 0.6%). While cohort effects were most evident for cervical cancer incidence and mortality, significant age, period, and cohort effects were found for all three gynaecological cancers evaluated. Conclusions These secular trends in incidence and mortality of gynaecological cancers in Shanghai likely reflect changing risk factor profiles and improved cancer prognosis over time, and suggest new priorities and call for additional efforts for gynaecological cancer prevention and control for women in China. © 2016 Elsevier Ltd. All rights reserved.
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