J Gynecol Oncol.  2024 May;35(3):e32. 10.3802/jgo.2024.35.e32.

Trends in the incidence and survival outcomes of endometrial cancer in Korea: a nationwide population-based cohort study

Affiliations
  • 1Department of Obstetrics and Gynecology, Research Institute of Medical Science, Konkuk University School of Medicine, Seoul, Korea
  • 2Division of Cancer Registration and Surveillance, National Cancer Center, Goyang, Korea
  • 3Center for Gynecologic Cancer, National Cancer Center, Goyang, Korea
  • 4Department of Obstetrics and Gynecology, Pusan National University Yangsan Hospital, Pusan, Korea
  • 5Gynecologic Cancer Branch, Research Institute and Hospital, National Cancer Center, Goyang, Korea
  • 6Department of Cancer Control and Population Health, National Cancer Center Graduate School of Cancer Science and Policy, National Cancer Center, Goyang, Korea
  • 7Division of Health Administration, College of Software and Digital Healthcare Convergence, Yonsei University, Wonju, Korea

Abstract


Objective
To evaluate trends in the incidence and survival outcomes of endometrial cancer (EC) based on the year of diagnosis, stage, age, and histologic types.
Methods
Women with primary EC diagnosed between 1999 and 2018, and who were followed up with until 2019, were identified from the Korea Central Cancer Registry using the International Classification of Diseases, 10th revision. The age-standardized rates (ASRs) of incidence, annual percent changes (APCs), and survival were estimated according to age, stage, histology, and year of diagnosis.
Results
The ASR for EC increased from 2.38 per 100,000 in 1999 to 7.29 per 100,000 in 2018 across all histologic types (APCs of 9.82, 15.97, and 7.73 for endometrioid, serous, and clear cell, respectively, p<0.001). There were significant differences in the 5-year survival rates based on histology (90.9%, 55.0%, and 68.5% for endometrioid, serous, and clear cell, respectively, p<0.001), stage (93.4%, 77.0%, and 31.0% for localized, regional, and distant, respectively, p<0.001), and age (93.0% for <50 years and 80.6% for ≥50 years, p<0.001). The 5-year survival was significantly better in the group diagnosed between 2000 and 2018 (85.9%) than that in the 1999–2008 group (83.3%) (p<0.001). This trend was only observed for endometrioid cancer (p<0.001).
Conclusion
The incidence of EC increased across the all 3 subtypes. Survival of patients with endometrioid histology improved over the past two decades, but remained static for serous or clear cell histology. Healthcare strategies to prevent EC incidence in at-risk populations and apply effective treatments for high-risk histology are needed.

Keyword

Endometrial Cancer; Incidence; Survival; Cancer Staging; Histology
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