Histopathologic subtyping of cervical adenocarcinoma reveals increasing incidence rates of endometrioid tumors in all age groups - A population basedstudy with review of all nonsquamous cervical carcinomas in Norway from 1966 to 1970, 1976 to 1980, and 1986 to 1990
Gc. Alfsen et al., Histopathologic subtyping of cervical adenocarcinoma reveals increasing incidence rates of endometrioid tumors in all age groups - A population basedstudy with review of all nonsquamous cervical carcinomas in Norway from 1966 to 1970, 1976 to 1980, and 1986 to 1990, CANCER, 89(6), 2000, pp. 1291-1299
BACKGROUND. The effect of histopathologic review and subclassification on i
ncidence rates for nonsquamous cell carcinoma (non-SCC) of the uterine cerv
ix in the Norwegian population was evaluated.
METHODS, All non-SCC from three 5-year periods (1966-70, 1976-80, and 1986-
90) were reviewed, classified, and graded.
RESULTS. Incidence rates were 1.2, 1.2, and 1.7 per 100,000 for adenocarcin
oma and 0.1, 0.3, and 0.5 per 100,000 for other carcinomas in the three per
iods. Adenocarcinomas increased in all age groups, most markedly in women y
ounger than 35 years. Incidence rates for both major subgroups of endocervi
cal (EC) and endometrioid (EM) carcinomas increased for women younger than
55 years. After 1976-80, the incidence rate for EC, but not for EM, decreas
ed in women older than 55 years. Endometrioid carcinoma became the dominant
histologic subtype in 1986-90. Shifts toward lower clinical stages and you
nger age were found for EC, EM, and carcinoma not otherwise specified (NOS)
. Patients with NOS, clear cell, serous, or glassy cell/undifferentiated ca
rcinoma were older, and their disease was diagnosed at higher stages. Distr
ibution of International Federation of Gynecology and Obstetrics (FIGO) sta
ges was. Stage I: 62%; Stage II: 21%; Stage III: 12%; and Stage IV: 5%. Dis
tribution of histologic subgroups was: EC:, 24%; EM: 21%; NOS: 16%; clear c
ell: 7%; adenosquamous: 7%; small cell: 6%; serous: 4%; undifferentiated: 3
%; and villoglandular carcinoma: 2%. Other subgroups were seen only sporadi
cally.
CONCLUSIONS, Incidence rates of non-SCC of the uterine cervix are increasin
g in Norway. Improvements in diagnostic procedures may explain shifts towar
d lower stage and age of patients but not the observed differences between
histologic subgroups. (C) 2000 American Cancer Society.