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. 2017 Feb;6(2):416-423.
doi: 10.1002/cam4.971. Epub 2017 Jan 19.

Increasing incidence of invasive and in situ cervical adenocarcinoma in the Netherlands during 2004-2013

Judith van der Horst  1 , Albert G Siebers  1 , Johan Bulten  1 , Leon F Massuger  2 , Inge McM de Kok  3
Affiliations

Increasing incidence of invasive and in situ cervical adenocarcinoma in the Netherlands during 2004-2013

Judith van der Horst et al. Cancer Med. 2017 Feb.

Abstract

In the developed world, the incidence of cervical squamous cell carcinoma has decreased, however, the incidence of adenocarcinoma in situ (AIS) and invasive adenocarcinoma increased, predominantly in young females. The goal of this study was to evaluate the most recent incidence rates of AIS, adenocarcinoma, and squamous cell carcinoma of the uterine cervix in the Netherlands in 2004-2013. By using Dutch national pathology and cancer registries, we calculated European standardized incidence rates (ESR) and estimated annual percentage changes (EAPC) for AIS during 2004-2013 and for invasive cervical carcinomas during 1989-2013. For AIS, presence or absence of concomitant cervical intraepithelial neoplasia (CIN) was explored. The estimated annual percentage change (EAPC) of squamous cell carcinoma decreased significantly in 1989-2013, predominantly in 1989-2003. The EAPC of invasive adenocarcinoma decreased in 1989-2003, but remained stable in 2004-2013. The EAPC of AIS increased significantly, predominantly in women of 25-39 years old. Of these AIS cases, 58.9% had concomitant CIN and AIS with concomitant CIN showed a significantly higher EAPC compared to AIS without CIN. Our conclusion is that despite a nationwide screening program for cancer of the uterine cervix, the incidence of adenocarcinoma in the Netherlands remained stable during 2004-2013 and the incidence of adenocarcinoma in situ increased. This was most predominant in cases with concomitant CIN and in younger females. The incidence of squamous cell carcinoma decreased in the same timeframe.

Keywords: Adenocarcinoma in situ; HPV; carcinoma; cervix; incidence.

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Figures

Figure 1
Figure 1
Scatterplot of the European standardized rates (ESR) of all cervical cancer and the different cancer types with correlation line in the period 1989–2013. (Data extracted from www.cijfersoverkanker.nl).
Figure 2
Figure 2
Scatterplot of the European Standardized Rates of AIS in the years 2004–2013 with correlation lines. ACA r = 0.330 with P = 0.322/AIS r = 0.951 with P = 0.000. ACA, adenocarcinoma; AIS, adenocarcinoma in situ.
Figure 3
Figure 3
Crudes rates of adenocarcinoma in situ in the age categories 25–29, 30–34, 35–39, and over 40 in the years 2004–2013 with fit line.
Figure 4
Figure 4
Scatterplot of the European Standardized Rates of adenocarcinoma in situ with (AIS+) and without (AIS‐) concomitant CIN in the years 2004–2013. AIS + r = 0.934 with P = 0.000 / AIS‐r = 0.928 with P = 0.000. CIN, cervical intraepithelial neoplasia.
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