Changing trends in gestational trophoblastic disease.
OBJECTIVE
The New Mexico Tumor Registry (NMTR) and Surveillance, Epidemiology and End Results (SEER) registries were utilized to determine (30+)-year trends in gestational trophoblastic disease and choriocarcinoma.


METHODS
Age-adjusted incidence rates of gestational trophoblastic disease per 100,000 woman-years (1973-2003) and ratios per live births and pregnancies were calculated using data abstracted from the NMTR and state vital records. SEER data (1973-2002) were used to calculate age-adjusted incidence rates, estimated annual percentage change (EAPC) and relative survival rates for choriocarcinoma.


RESULTS
In New Mexico there were 1,153 cases affecting 377 non-Hispanic whites, 504 Hispanics and 241 American Indians, with respective incidence rates of 3.494, 5.150 and 9.991 (p < 0.0001). American Indian incidence rates decreased 53.3%, from 13.34 (1988-1992) to 6.23 (1998-2002). Within SEER (1973-2002), there were 504 gestational choriocarcinomas. The 30-year incidence rate was 0.132 and decreased by 37.7% (EAPC, -2.1% per year; p=0.0001)-by 40.1% for whites, 55.9% for blacks and 62.1% for others. However, over the previous 10 years, rates among blacks (0.097 vs. 0.259, p = 0.01) and for distant disease (0.044 vs. 0.071, p = 0.046) increased.


CONCLUSIONS
Disparities in incidence rates by race/ethnicity in New Mexico are decreasing. An increase in rates among blacks and distant disease diagnosis may be the consequence of fewer regional trophoblastic centers in the United States.
Smith
Harriet O
HO
Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of New Mexico Health Sciences Center, Albuquerque, NM 87131-5286, USA. hsmith@salud.unm.edu
Wiggins
Charles
C
Verschraegen
Claire F
CF
Cole
Laurence W
LW
Greene
Heather M
HM
Muller
Carolyn Y
CY
Qualls
Clifford R
CR
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002648:Child; D018572:Disease-Free Survival; D005006:Ethnicity / Q000706:statistics & numerical data; D005260:Female; D031901:Gestational Trophoblastic Disease / Q000453:epidemiology* / Q000208:ethnology / Q000209:etiology / Q000401:mortality; D019456:Health Transition; D006801:Humans; D015994:Incidence; D008427:Maternal Health Services; D008428:Maternal Mortality / Q000639:trends; D008875:Middle Aged; D009516:New Mexico / Q000453:epidemiology; D011159:Population Surveillance; D011247:Pregnancy; D012042:Registries; D018426:SEER Program; D016019:Survival Analysis; D014594:Uterine Neoplasms / Q000453:epidemiology* / Q000208:ethnology / Q000209:etiology / Q000401:mortality