Gynaecological cancers in Umbria (Italy): trends of incidence, mortality and survival, 1978–1998

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Objective: For the period 1978–1998 incidence, mortality and survival from gynaecological cancers in the Umbria region (Central Italy) were examined. Study design: Mortality data were derived from the National Institute of Statistics while incidence and survival data were provided by an ad hoc survey carried out over the period 1978–1982 and by the Umbrian Population-Based Cancer Registry operating since 1994. Age-standardised mortality and incidence rates were calculated. Survival was assessed using the Estève method. Mortality trends were analysed by joinpoint regression model. Results: In the Umbria Region, over the period 1978–1998, the incidence rate of cervical cancer decreased, while those for endometrial and ovarian cancers rose. By contrast, the mortality rates from ovarian and endometrial cancers decreased, while that for cervical cancer rose slightly. Comparing relative survival rates, at 5 years an increase in survival was reported for ovarian cancer, cervical cancer remained constant and endometrial cancer slightly decreased; at 1 year only the ovarian cancer survival improved. Nevertheless, age-standardised survival rates showed that survival improved in all examined sites. Conclusions: The improvement in diagnosis and in data coding could have determined an increase in endometrial and ovarian cancer incidence, while the dramatic decrease in cervical cancer incidence is probably due to the effectiveness of cervical screening.