Cervical Cancer Incidence, Mortality, and Survival Among Asian Subgroups in California, 1990-2004

Public Health Institute, California Cancer Registry, Sacramento, California 95825, USA.
Cancer (Impact Factor: 4.89). 11/2008; 113(10 Suppl):2955-63. DOI: 10.1002/cncr.23752
Source: PubMed


Aggregated cancer statistics for Asians mask important differences in cancer burden among Asian subgroups. The purpose of this study was to describe the relative patterns of cervical cancer incidence, mortality, and survival among Chinese, Filipino, Japanese, Korean, South Asian, and Vietnamese women in California, using data from the California Cancer Registry.
All cervical cancer cases diagnosed among the 6 subgroups and non-Hispanic whites (NHW) from 1990 to 2004 were identified and used to calculate incidence and mortality rates and trends. The Kaplan-Meier method was used to calculate 5- and 10-year survival probabilities by subgroup, and Cox proportional hazards methodology was used to calculate survival differences adjusted for race and ethnicity, age, stage at diagnosis, socioeconomic status, and treatment factors.
Vietnamese and Korean women experienced greater cervical cancer incidence and mortality than NHW women, whereas rates among Chinese, Japanese, and South Asians were comparable or lower. Five-year unadjusted survival probabilities were greatest for South Asians (86%) and Koreans (86%), followed by Vietnamese (82%), Chinese (79%), and Filipinos (79%), as compared with NHW (78%) and Japanese (72%). The adjusted risk of cervical cancer death was significantly lower for South Asians, Koreans, Vietnamese, and Filipinos than for NHW women, but not for Chinese and Japanese.
Cervical cancer incidence rates vary substantially across the major Asian subgroups. Despite higher incidence and mortality rates compared with NHW women, Vietnamese, Koreans, and Filipinos have better survival outcomes. Further studies are needed to examine the factors behind these survival differences.

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    • "Accounted for one-third of the world's total annual new cases, 83.9% of cervical cancer in China accepted surgical treatment [2]. The situation of high surgical rate is similar for most patients worldwide in the past decade [2–4]. Radical hysterectomy (RH) with pelvic lymphadenectomy is the mainstay of surgical treatment for early stage cervical cancer and stage II endometrial cancer according to the guideline version 2011 of National Comprehensive Cancer Network [5, 6]. "
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    • "Cervical cancer incidence and mortality fell in each group during this period. The APCs in the rates were −8.7% for Vietnamese, -5.1% among Koreans, -4.6% among Filipinos, -5.4% for Chinese and −2.3% among non-Hispanic Whites [10]. None of these studies related the trends in incidence or mortality with trends in cervical screening, which is largely opportunistic in the USA. "
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