Cancer Res Treat.  2017 Apr;49(2):526-533. 10.4143/crt.2016.316.

Trends and Age-Period-Cohort Effects on the Incidence and Mortality Rate of Cervical Cancer in Korea

• Moon EK
• Oh CM
• Won YJ
• Lee JK
• Jung KW
• Cho H
• Jun JK
• Lim MC
• Ki M

• KMID: 2378126
• DOI: http://doi.org/10.4143/crt.2016.316

Abstract

PURPOSE
This study was conducted to describe the trends and age-period-cohort effects on the incidence and mortality rate of cervical cancer in Korea.
MATERIALS AND METHODS
The incidence and mortality rate of cervical cancer among ≥ 20-year-old women from 1993 to 2012 were obtained from the Korea Central Cancer Registry and the Korean Statistical Information Service. Age-standardized rates were calculated and Joinpoint regression was used to evaluate the trends in the incidence and mortality rate. Age-period-cohort analysis was performed to investigate the independent effects of age, period and cohort.
RESULTS
The incidence of cervical cancer decreased from 32.8 per 100,000 in 1993 to 15.9 per 100,000 in 2012 (annual percent change [APC], -3.9%; 95% confidence interval [CI], -4.2% to -3.6%). The mortality rate decreased from 5.2 per 100,000 in 1993 to 2.1 per 100,000 in 2012 (APC, -4.8%; 95% CI, -5.1% to -4.4%); however, the incidence and mortality rates among young women (< 30 years old) increased. An age-period-cohort model of the incidence and mortality rate showed decreasing period effects between 1993 and 2008 and decreasing cohort effects between 1928 and 1973, while birth cohorts after 1973 exhibited slight increases in the incidence and mortality rate of cervical cancer.
CONCLUSION
Recent decreases in the incidence and mortality rate of cervical cancer were due to decreases in the period and cohort effects, which reflect the implementation of a cancer screening program and changes in lifestyle. However, our findings also highlighted an increase in cohort effects on the incidence and mortality rate among young women born after 1973.

Keyword

Uterine cervical neoplasms; Incidence; Mortality; Age-period-cohort analysis; Trends

MeSH Terms

Cohort Effect
Cohort Studies
Early Detection of Cancer
Female
Humans
Incidence*
Information Services
Korea*
Life Style
Mortality*
Parturition
Uterine Cervical Neoplasms*
Young Adult

Figure

• 

  Fig. 1. Incidence rates of cervical cancer. (A) The age-specific incidences rates of cervical cancer according to time period; each line connects the age-specific incidence for a 5-year period. (B) The birth cohort–specific incidence rates of cervical cancer according to age group; each line connects the birth cohort–specific incidence for a 5-year age group.

• 

  Fig. 2. Mortality rates for cervical cancer. (A) The age-specific mortality rates of cervical cancer according to time period; each line connects the age-specific mortality rate for a 5-year period. (B) The birth cohort–specific mortality rates for cervical cancer according to age group; each line connects the birth cohort–specific mortality rate for a 5-year age group.

• 

  Fig. 3. Age-period-cohort analysis of cervical cancer. (A) The incidences of cervical cancer in Korea. The blue line indicates the age effect and 95% confidence interval, the red line indicates the period effect and 95% confidence interval, and the green line indicates the cohort effect and corresponding 95% confidence interval. (B) The mortality rates for cervical cancer in Korea. The blue line indicates the age effect and 95% confidence interval, the red line indicates the period effect and 95% confidence interval, and the green line indicates the cohort effect and corresponding 95% confidence interval.

Reference

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