Obstet Gynecol Sci.  2023 Nov;66(6):545-561. 10.5468/ogs.23208.

Incidence and survival of gynecologic cancer including cervical, uterine, ovarian, vaginal, vulvar cancer and gestational trophoblastic neoplasia in Korea, 1999-2019: Korea Central Cancer Registry

• Yun BS
• Park EH
• Ha J
• Lee JY
• Lee KH
• Lee TS
• Lee KJ
• Kim YJ
• Jung KW
• Roh JW

• KMID: 2547856
• DOI: http://doi.org/10.5468/ogs.23208

Abstract

Objective
To investigate the incidence, trends, and survival rates of all gynecologic cancers using the Korea Central Cancer Registry (KCCR) database from 1999-2019.
Methods
Gynecologic cancer data were obtained from the KCCR database between 1999 and 2019. Age-standardized incidence rates (ASRs), annual percentage changes, and average annual percentage changes (AAPCs) were calculated. The relative survival rate (RSR) was reported by age group, stage, and 6-year period (I: 1999-2005, II: 2006-2012, III: 2013- 2019).
Results
The gynecologic cancer ASRs were 26.2 and 24.9 per 100,000 individuals in 1999 and 2019, respectively. Trends of incidence in gynecologic cancer revealed a decrease in cervical cancer and gestational trophoblastic neoplasia (GTN) with AAPCs of -3.4 and -4.3, respectively. Conversely, the incidence of uterine, ovarian, and vulvar cancers increased with AAPCs of 4.7, 2.3, and 2.1, respectively. AAPC for vaginal cancer showed no change. The 5-year survival rate was highest for GTN (90.5%) and lowest for vaginal cancer (56.6%). An increase in age was correlated with poorer survival rates across all gynecologic cancers, excluding vaginal cancer. For all gynecologic cancer types, the prognosis deteriorates with advancing cancer stages. The RSR of uterine cancer improved consistently across all periods. The ovarian cancer RSR improved more in period III than in periods I or II. Additionally, the vulvar cancer RSR improved more in periods II and III than in period I.
Conclusion
In Korea, the incidence of cervical cancer and GTN decreased, whereas the incidence of uterine, ovarian, and vulvar cancer increased from 1999 to 2019. The RSR for uterine, ovarian, and vulvar cancers showed consistent improvements over different periods. Effective screening programs and the adoption of advanced treatments may be necessary to further reduce the burden of gynecologic cancer.

Keyword

Incidence; Survival; Gynecologic neoplasms; Uterine cervical neoplasms; Ovarian neoplasms

Figure

• 

  Fig. 1 Incidence of gynecologic cancer in Korea, from 1999 to 2019. (A) The annual number of new cases and deaths. (B) The age-standardized rates of incidence by types of gynecologic cancer. (C) Average annual percent changes (AAPC) in the incidence by age group and types of gynecologic cancer. (D) Distribution of SEER stage by types of gynecologic cancer. (E) Secular trends of SEER stage distribution. (F) The percentages of types of gynecologic cancer in 1999 and 2019. *Statistically significant (P<0.05). GTN, gestational trophoblastic neoplasia; SEER, Surveillance, Epidemiology, and End Results.

• 

  Fig. 2 Relative survival rate (RSR) of gynecologic cancer in Korea, from 1999 to 2019. (A) RSR of gynecologic cancer by cancer types. (B) RSR of uterine cancer by histologic type. (C) RSR of ovarian cancer by histologic type.

• 

  Fig. 3 Relative survival rate of gynecologic cancer by age groups in Korea, from 1999 to 2019. (A) Cervical cancer. (B) Uterine cancer. (C) Ovarian cancer. (D) Vaginal cancer. (E) Vulvar cancer. (F) Gestational trophoblastic neoplasia (GTN).

• 

  Fig. 4 Relative survival rate of gynecologic cancer by SEER stage in Korea by, from 2006 to 2019. (A) Cervical cancer. (B) Uterine cancer. (C) Ovarian cancer. (D) Vaginal cancer. (E) Vulvar cancer. (F) Gestational trophoblastic neoplasia (GTN). SEER, Surveillance, Epidemiology, and End Results.

• 

  Fig. 5 The trend of 5-year survival rate of gynecologic cancer by year of diagnosis in Korea, from 1999 to 2019. (A) The trend of 5-year survival rate by year of diagnosis. (B) The trend of 5-year survival rate of cervical, uterine, and ovarian cancer by SEER stage between period 2006–2012 and 2013–2019. *Statistically significant (P<0.05). GTN, gestational trophoblastic neoplasia; SEER, Surveillance, Epidemiology, and End Results.

Reference

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