title: Incidence and survival rates for female malignant germ cell tumors.
abstract: OBJECTIVE
  To evaluate 30-year, population-based trends in incidence and survival rates for malignant germ cell tumors originating within the female genital tract.
  
  
  METHODS
  Surveillance, Epidemiology, and End Results data were used to identify malignant germ cell tumors (1973-2002). Overall and 5-year incidence rates, estimated annual percentage change, and survival rates were calculated and compared by age at diagnosis, race, stage, and histology.
  
  
  RESULTS
  Of 1,262 cases, there were 414 (32.8%) dysgerminomas, 449 (35.6%) immature teratomas, 37 (2.9%) mature teratomas with malignant degeneration, and 362 (28.7%) mixed germ cell tumors. The 30-year, age-adjusted incidence rate per 100,000 women-years was 0.338, decreasing by 29.4% for dysgerminomas (P = .18) and by 31.5% for mixed germ cell tumors (P = .22). Other nonwhites had higher rates than whites and blacks, but dysgerminoma rates were higher in whites and other nonwhites than in blacks. Using the registries for expanded races, rates were higher for Asian/Pacific Islanders (P = .059) and Hispanics (P = .07). By age at diagnosis, 15-19 year olds had the highest rates and the only significant change in rates (37.5% increase, P = .008). The 5-year relative survival was 83.9%. Survival rates improved significantly over calendar time and varied by histologic subtype, race, stage of disease, and age at diagnosis.
  
  
  CONCLUSIONS
  Over the past 30 years, germ cell tumor incidence rates have declined in women and differ from rising trends reported for testicular tumors. Survival rates have improved but were lower for older women and for nondysgerminoma subtypes.
authors.affiliation: Department of Obstetrics and Gynecology, University of New Mexico Health Sciences Center, Albuquerque, New Mexico 87131-5286, USA. Hsmith@salud.unm.edu
authors.forename: Harriet O
authors.initials: HO
authors.lastname: Smith
authors.forename: Marianne
authors.initials: M
authors.lastname: Berwick
authors.forename: Claire F
authors.initials: CF
authors.lastname: Verschraegen
authors.forename: Charles
authors.initials: C
authors.lastname: Wiggins
authors.forename: Letitia
authors.initials: L
authors.lastname: Lansing
authors.forename: Carolyn Y
authors.initials: CY
authors.lastname: Muller
authors.forename: Clifford R
authors.initials: CR
authors.lastname: Qualls
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005006:Ethnicity; D005260:Female; D006801:Humans; D015994:Incidence; D007198:Indians, North American; D007223:Infant; D008875:Middle Aged; D009373:Neoplasms, Germ Cell and Embryonal / Q000208:ethnology* / Q000401:mortality* / Q000473:pathology; D010051:Ovarian Neoplasms / Q000208:ethnology* / Q000401:mortality* / Q000473:pathology; D018426:SEER Program; D015996:Survival Rate / Q000639:trends; D014481:United States / Q000453:epidemiology; D044465:White People