Abstract

Few studies have reported on the increase in cervical cancer incidence in Japan. We aimed to determine the relevant trends in the metropolitan regions of Japan and to identify the population with the highest risk, based on histological subtype, cancer stage, and diagnostic processes. Using population-based data (2009–2013), we identified 2110 women, aged ≥20 years, with cervical cancer. We estimated the age-standardized and age-specific incidence rates of cervical cancer for the study period based on the 1985 national model population. The average annual percent change (AAPC) and 95% confidence interval (CI) were calculated using the joinpoint regression analysis. We stratified the analyses based on histological subtypes, stage, and diagnostic process via cancer screening. The increase in the overall age-standardized incidence was not significant. However, the increase was significant for women aged 30–39 years (AAPC 20.0%/year, 95% CI: 9.9–31.1), which was attributable to the increase in the incidence of the squamous cell carcinoma (SCC) subtype (AAPC 23.1%/year, 95% CI: 10.7–36.8). Among younger women, aged <50 years, further stratification showed an increase in the undiagnosed early-stage SCC subtype via cancer screening. In Japan, the incidence of HPV-related cervical cancer has been increasing in undiagnosed younger women.

Highlights

  • Cervical cancer is the fourth most common cancer that affects women worldwide, in addition to ranking fourth among the causes of cancer-related mortality [1]

  • We examined the trends of cervical cancer incidence in Japan

  • We identified patients with cervical cancer who were diagnosed via cancer screening in the public and private sectors

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Summary

Introduction

Cervical cancer is the fourth most common cancer that affects women worldwide, in addition to ranking fourth among the causes of cancer-related mortality [1]. In Japan, the estimated number of patients with cervical cancer newly diagnosed in 2016 was approximately 34,000 (23,000 cases of carcinoma in situ (CIS) and 11,000 cases of invasive cancer) [2]. The incidence of cervical cancer remains higher in developing countries than in developed countries [1]. In 2013, the age-standardized incidence rates for invasive cervical cancer, defined by the diagnosis code C53 in the International Classification of Diseases, 10th revision (ICD-10), were 15.7/100,000 population in developing countries and 9.6/100,000 population in developed countries [3]. Res. Public Health 2020, 17, 7401; doi:10.3390/ijerph17207401 www.mdpi.com/journal/ijerph

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