Trends in cervical cancer mortality in Korea 1993-2002: corrected mortality using national death certification data and national cancer incidence data.
Cervical cancer is a major health problem for Korean women, accounting for 9.8% of new female cancer cases, even though incidence rates have been decreasing. The Korean cervical cancer mortality rate for 1993-2002 based on National Statistical Office data shows an increasing trend, but the actual rates are thought to have decreased by epidemiologists, clinicians and other cancer experts. To explain this gap and solve this problem, we corrected the number of cervical cancer deaths by comparing death certificate cases of unspecified uterine cancer data with the national cancer incidence databases of entire cancer registries in Korea. We used 2 different methods to make a correction. First, we considered "uterus, unspecified" deaths previously registered as "cervix, uterine" cases misclassified and added them to the cervical cancer deaths. Alternatively, we multiplied the total number of registered unspecified uterine cancer deaths by age-specific proportions of registered incident cervical cancer cases among all cancers and added the product to cervical cancer deaths. The overall corrected age-standardized cervical cancer mortality rates per 100,000 women decreased from 5.2 in 1993 to 3.9 in 2002 (estimated annual percentage change (EAPC): -4.05%, 95% CI: -4.88, -3.22). While cervical cancer mortality showed a decreasing tendency in women aged 30-69 years, it increased substantially in women aged > or =70 years (EAPC: 3.62%, 95% CI: 1.92-5.35). Results of this study will provide evidence-based foundation for the evaluation of the existing cervical cancer-screening programs.
Shin
Hai-Rim
HR
Research Institute for National Cancer Control and Evaluation, National Cancer Center, Goyang, Korea. hrshin@ncc.re.kr
Park
Sohee
S
Hwang
Soon-Young
SY
Kim
Jung-Eun
JE
Jung
Kyu-Won
KW
Won
Young-Joo
YJ
Hwang
Seung-Sik
SS
Yim
Seon-Hee
SH
Choi
Kui Son
KS
Park
Eun-Cheol
EC
Park
Sang-Yoon
SY
Kim
Jae Weon
JW
Lee
Hyo-Pyo
HP
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D007231:Infant, Newborn; D007723:Korea; D008403:Mass Screening; D008875:Middle Aged; D012042:Registries; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000401:mortality*