Cervical Cancer Incidence in the US-Affiliated Pacific Islands.

IF 22.5 1区 医学 Q1 ONCOLOGY
Sameer V Gopalani,Jin Qin,Janos Baksa,Trevor D Thompson,Mona Saraiya,Virginia Senkomago,Paran Pordell,Youngju Jeong,Neal A Palafox,Martina Reichhardt,Lee E Buenconsejo-Lum
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引用次数: 0

Abstract

Importance The World Health Organization has called for eliminating cervical cancer as a public health problem. Accurate and up-to-date estimates of population-based cervical cancer incidence are essential for monitoring progress toward elimination and informing local cancer control strategies, but these estimates are lacking for the US-Affiliated Pacific Islands (USAPI). Objective To calculate age-standardized incidence rates for cervical cancer in the 6 USAPI and compare these rates with rates in the US (50 states and the District of Columbia). Design, Setting, and Participants This cross-sectional study used population-based data from the Pacific Regional Central Cancer Registry for women aged 20 years or older who were diagnosed with invasive cervical cancer from January 1, 2007, to December 31, 2020. The registry comprises data on all cervical cancers from the USAPI, which include 3 US territories (American Samoa, Commonwealth of the Northern Mariana Islands, and Guam) and 3 freely associated states (Federated States of Micronesia [FSM], Republic of the Marshall Islands [RMI], and Republic of Palau). Data were analyzed from July 10, 2023, to November 28, 2023. Main Outcomes and Measures The main outcome was age-standardized cervical cancer incidence rates, stratified by age, stage, and histologic code for the USAPI using population estimates from 3 different sources (US Census Bureau International Database, United Nations Population Division, and Pacific Data Hub). Rate ratios were calculated to compare incidence rates between the USAPI and the US. Results From 2007 to 2020, 409 cases of cervical cancer were diagnosed in the USAPI (median age at diagnosis, 46.0 years [25th-75th percentile, 39.0-55.0 years]), with an age-standardized incidence rate ranging from 21.7 (95% CI, 19.6-23.9) to 22.1 (95% CI, 20.0-24.4) per 100 000 women, depending on the population estimate. Incidence rates were highest in RMI, ranging from 58.1 (95% CI, 48.0-69.7) to 83.4 (95% CI, 68.3-101.0) per 100 000 women, followed by FSM, ranging from 28.7 (95% CI, 23.4-34.9) to 29.8 (95% CI, 24.3-36.3) per 100 000 women. Compared with the US, incidence rates were highest in RMI (rate ratio, 5.7 [95% CI, 4.7-6.8] to 8.2 [95% CI, 6.7-9.9]) and FSM (rate ratio; 2.8; 95% CI, 2.3-3.4). Of all cases in the USAPI, 213 (68.2%) were diagnosed at a late stage. Conclusions and Relevance In this cross-sectional study, cervical cancer remained a major public health issue in some USAPI, with RMI reporting the highest incidence rates. The findings suggest that improvements in human papillomavirus vaccination and cancer screening coverage through efforts tailored to the unique geographic, sociocultural, economic, and health care landscape of the USAPI may reduce the burden of cervical cancer.
隶属美国的太平洋岛屿的宫颈癌发病率。
重要性世界卫生组织呼吁消除宫颈癌这一公共卫生问题。准确和最新的宫颈癌发病率估计值对于监测消除宫颈癌的进展情况和为当地癌症控制策略提供信息至关重要,但美属太平洋岛屿(USAPI)却缺乏这些估计值。这项横断面研究使用了太平洋地区中央癌症登记处的人口数据,这些数据针对的是 2007 年 1 月 1 日至 2020 年 12 月 31 日期间被诊断出患有浸润性宫颈癌的 20 岁及以上女性。该登记处包括来自美国太平洋地区的所有宫颈癌数据,其中包括 3 个美国领地(美属萨摩亚、北马里亚纳群岛联邦和关岛)和 3 个自由联系州(密克罗尼西亚联邦、马绍尔群岛共和国和帕劳共和国)。主要结果和测量指标主要结果是年龄标准化的宫颈癌发病率,按年龄、分期和组织学代码进行分层,使用 3 个不同来源(美国人口普查局国际数据库、联合国人口司和太平洋数据中心)的人口估计值对美国亚太地区的宫颈癌发病率进行分析。结果从 2007 年到 2020 年,美国亚太地区共诊断出 409 例宫颈癌病例(诊断时的中位年龄为 46.0 岁 [第 25-75 百分位数,39.0-55.0 岁]),年龄标准化发病率为每 10 万名妇女中 21.7 例(95% CI,19.6-23.9 例)到 22.1 例(95% CI,20.0-24.4 例),具体取决于人口估计值。马绍尔群岛的发病率最高,每 100 000 名妇女中的发病率从 58.1(95% CI,48.0-69.7)到 83.4(95% CI,68.3-101.0)不等,其次是密克罗尼西亚联邦,每 100 000 名妇女中的发病率从 28.7(95% CI,23.4-34.9)到 29.8(95% CI,24.3-36.3)不等。与美国相比,RMI(比率比为 5.7 [95% CI, 4.7-6.8] 至 8.2 [95% CI, 6.7-9.9])和 FSM(比率比为 2.8; 95% CI, 2.3-3.4)的发病率最高。在美国亚太地区的所有病例中,有 213 例(68.2%)是在晚期确诊的。结论和相关性在这项横断面研究中,宫颈癌仍然是美国亚太地区一些国家的主要公共卫生问题,其中马绍尔群岛的发病率最高。研究结果表明,根据美国亚太地区独特的地理、社会文化、经济和医疗保健状况,提高人类乳头瘤病毒疫苗接种率和癌症筛查覆盖率,可以减轻宫颈癌的负担。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
JAMA Oncology
JAMA Oncology Medicine-Oncology
自引率
1.80%
发文量
423
期刊介绍: JAMA Oncology is an international peer-reviewed journal that serves as the leading publication for scientists, clinicians, and trainees working in the field of oncology. It is part of the JAMA Network, a collection of peer-reviewed medical and specialty publications.
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