Trends in gestational choriocarcinoma: a 27-year perspective.
OBJECTIVE
To evaluate trends in incidence and survival rates for gestational choriocarcinoma with the use of population-based data.


METHODS
Overall and 5-year average age-adjusted incidence rates were computed with the Surveillance, Epidemiology, and End Results program public-use database. Differences by age at diagnosis, race, stage, registry, and over calendar time were compared by Poisson regression, and survival censored for deaths other than choriocarcinoma by log-rank tests and Cox's proportional hazard ratios.


RESULTS
Between 1973 and 1999, 450 cases were recorded. The annualized age-adjusted incidence rate for choriocarcinoma was 0.133 per 100,000 woman-years and decreased by 49.7% (2.8% per year). By race (whites, blacks, and others), incidence rates declined by 62.3%, 27.2%, and 54.3%, respectively. In the Poisson model evaluating incidence rates, age, race, registry, and stage were significant main effects. Compared with whites, the relative risk was higher for blacks (2.14, 95% confidence interval [CI] 1.60, 2.86) and others (2.30, 95% CI 1.67, 3.18). Rates were highest in Utah and lowest in Iowa. By age at diagnosis, rates were higher in 20-39-year-olds. The 5-year relative survival rate was 89.5%. Censored survival was significantly lower among blacks (whites 92.4%, blacks 84.9%, others 87.1%, P = .045), for advanced disease (localized 94.5%, regional 92.9%, distant 87.1%, P = .02), and with increasing age at diagnosis (P = .017). Age and calendar time significantly influenced censored survival independent of stage and registry.


CONCLUSIONS
Gestational choriocarcinoma incidence rates have declined and survivals have improved, but blacks continue to have higher incidence and lower survival rates.
Smith
Harriet O
HO
Department of Obstetrics and Gynecology, University of New Mexico Health Sciences Center, Albuquerque, New Mexico 87131-5286, USA. hsmith@salud.unm.edu
Qualls
Clifford R
CR
Prairie
Beth A
BA
Padilla
Luis A
LA
Rayburn
William F
WF
Key
Charles R
CR
D000293:Adolescent; D000328:Adult; D002648:Child; D002822:Choriocarcinoma / Q000453:epidemiology* / Q000208:ethnology / Q000209:etiology / Q000401:mortality; D005006:Ethnicity / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D011247:Pregnancy; D016016:Proportional Hazards Models; D012042:Registries; D016019:Survival Analysis; D014481:United States / Q000453:epidemiology; D014594:Uterine Neoplasms / Q000453:epidemiology* / Q000208:ethnology / Q000209:etiology / Q000401:mortality