Comparison of gynecologic cancer risk factors, incidence and mortality trends between South Korea and Israel, 1999-2013.

Abstract

To discuss possible causes of disparities in incidence and mortality rates of ovarian cancer, uterine cancer and cervical cancer between two diverse populations from east and west Asia. Incidence and mortality data from 1999 to 2013 were extracted from Korean and Israeli cancer registries. Age-standardized rates and annual percent changes were calculated. Trends were analyzed using Joinpoint analysis and discussed with respect to risk factor exposure. Age-standardized rate of ovarian cancer significantly increased in Korea (annual percent change 1.7%) but decreased among Jews (annual percent change -2.15%). Age-standardized rate of uterine cancer increased among both Koreans and Israeli Jews (annual percent changes 5.8 and 1.17%, respectively). Incidence of cervical cancer significantly decreased in Korea (annual percent change -3.8%) while remained stable on Israel. Mortality trends paralleled incidence trends with a significant increase in ovarian cancer and uterine cancer mortality in Korea (annual percent changes 1.2 and 4.6%, respectively) and a drop in cervical cancer mortality from 2002 (annual percent change -5.8%). Among Israeli Jews, uterine cancer mortality increased (annual percent change 1.01%), while ovarian cancer mortality decreased (annual percent change -0.58%). Uterine cancer mortality among Arabs declined (annual percent change -0.5%), while cervical cancer mortality remained unchanged. Gynecologic malignancies show different incidence trends in Korea and Israel. Uterine cancer is rising in both countries and is correlated to changing trends in obesity and dietary habits. Ovarian cancer is rising in Korea but declining among Israeli Jews along with changes in parity, childbearing age, contraceptive use and increasing awareness to BRCA gene carriers and risk reduction salpingo-oophorectomy. Cervical cancer is declining in Korea along with an effective screening program implemented. Mortality trends follow incidence trends in both countries.