Changing Incidence of Invasive Adenocarcinoma of the Uterine Cervix in East Anglia

Abstract

Objective— To determine trends in incidence of invasive adenocarcinoma of the uterine cervix in East Anglia. Methods— Cervical cancer incidence data for both squamous cell carcinomas and adenocarcinomas were obtained from the East Anglian Cancer Registry for the period 1971–94. Similar data were obtained for England and Wales. European age standardised rates (ASRs) were used for comparisons. Results— The mean incidence (ASR) of cervical adenocarcinoma was 0.85 per 10s in 1971–76, rising to 2.54 per 105 in 1989–94. There has been a marked age shift, with the main increase in incidence occurring in younger women aged 30–39. The mean incidence (ASR) of squamous cell carcinoma of the cervix has decreased from 9.78 to 8.74 per 10s over the periods 1971–76 and 1989–94. Again there has been an age shift, moving from a single incidence peak in the 4S-S9 age band in earlier years to incidence peaks in both the 30–39 and 55–69 age bands in more recent years. Similar trends were noted when data for England and Wales were analysed. Birth cohort analyses show that both tumours are occurring progressively earlier (about five years earlier in each five year birth cohort). Conclusion— Although the overall incidence of cervical carcinoma is declining, this study has shown an increased incidence of cervical adenocarcinoma, particularly in the younger age groups. In future it would seem advisable to publish separate incidence and mortality data for squamous cell carcinoma and adenocarcinoma of the uterine cervix. All practitioners involved in the cervical cancer screening programme would then be aware of the very real significance of this tumour.