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Epidemiology of Cervical Cancer

Article information

J Korean Med Assoc. 2007;50(9):762-768
Publication date (electronic) : 2007 September 30
doi : https://doi.org/10.5124/jkma.2007.50.9.762
Kyu Wan Lee, MD, Jae Yun Song, MD
Department of Obstetrics and Gynecology, Korea University College of Medicine, Korea. pumplee@kumc.or.kr, yuni105@yahoo.co.kr

Abstract

Invasive cancer of the cervix is considered a pre-ventable disease because it has a long preinvasive state, cervical cytology screening programs are currently available, and the treatment of pre-invasive lesions is effective. Cancer of the cervix is the second most common cancer among women worldwide, with an estimated 493,000 new cases and 274,000 deaths in 2002. The highest incidence rates are observed in sub-Saharan Africa, Melanesia, Latin America and the Caribbean, South-Central Asia, and South East Asia. In Korea, cervical cancer is the fifth most common cancer among women with over 3,000 new cases every year. Age-standardized incidence rate (ASR) is 15.5 per 100,000, which is lower than those in developing countries but higher than in western countries such as Europe and North America. The patients' mean parity is 2.59, and the range of age in peak incidence is 40~49 years (29.8%), followed by 50~59 years (21.9%). As the age goes on, more advanced stage cancer is frequent. Squamous cell carcinoma is the most common cell type, and adenocarcinoma is more frequent among those under 60 years old. Operation (56.0%) is the major treatment modality under stage IIa, and concurrent chemoradiation (31.6%) is the major treatment over stage IIb. The 5year survival rate is 73.9%. It is generally thought that human papillomavirus (HPV) test and HPV vaccine might play an important role in lowering the incidence of cervical cancer, and continuous epidemiologic studies will support its usefulness and efficacy.

Keywords: Epidemiology; Cervical cancer; Incidence; Human papillomavirus

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Article information Continued

Copyright © 2007 Korean Medical Association

Figure 1

Figure 1

An epidemiologic model of cervical carcinogenesis. The major steps in cervical carcinogenesis are human papillomavirus (HPV) infection (balanced by viral clearance), progression to precancer (partly offset by regression of precancer), and invasion. The persistence of oncogenic HPV types is necessary for progression and invasion. HPV infection is frequently but not necessarily associated with cytologic and histologic abnormalities(3).

Figure 2

Figure 2

Age-standardized (world) incidence of cervical cancer in 2002(4).

Figure 3

Figure 3

Age-standardized (world) incidence of cervical cancer by histological subtypes in selected cancer registries circa 1993~1997(5).

Figure 4

Figure 4

Age-standardized incidence and mortality rate(10).

Figure 5

Figure 5

Annual report of the Korea Central Cancer Registry. (2002.1~2002.12).

Figure 6

Figure 6

A) The incidence of cervical cancer by year, B) The stage distribution of cervical cancer by year(13).