title: Changing trends in gestational trophoblastic disease.
abstract: 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.
authors.affiliation: 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
authors.forename: Harriet O
authors.initials: HO
authors.lastname: Smith
authors.forename: Charles
authors.initials: C
authors.lastname: Wiggins
authors.forename: Claire F
authors.initials: CF
authors.lastname: Verschraegen
authors.forename: Laurence W
authors.initials: LW
authors.lastname: Cole
authors.forename: Heather M
authors.initials: HM
authors.lastname: Greene
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; 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