title: Trends in gynecologic cancer mortality in East Asian regions.
abstract: OBJECTIVE
  To evaluate uterine and ovarian cancer mortality trends in East Asian countries.
  
  
  METHODS
  For three Asian countries and one region (Japan, Korea, Singapore, and Hong Kong), we extracted number of deaths for each year from the World Health Organization (WHO) mortality database, focusing on women ≥20 years old. The WHO population data were used to estimate person-years at risk for women. The annual age-standardized, truncated rates were evaluated for four age groups. We also compared age-specific mortality rates during three calendar periods (1979 to 1988, 1989 to 1998, and 1999 to 2010). Joinpoint regression was used to determine secular trends in mortality. To obtain cervical and uterine corpus cancer mortality rates in Korea, we re-allocated the cases with uterine cancer of unspecified subsite according to the proportion in the National Cancer Incidence Databases.
  
  
  RESULTS
  Overall, uterine cancer mortality has decreased in each of the Asian regions. In Korea, corrected cervical cancer mortality has declined since 1993, at an annual percentage change (APC) of -4.8% (95% confidence interval [CI], -5.3 to -4.4). On the other hand, corrected uterine corpus cancer mortality has abruptly increased since 1995 (APC, 6.7; 95% CI, 5.4 to 8.0). Ovarian cancer mortality was stable, except in Korea, where mortality rates steadily increased at an APC of 6.2% (95% CI, 3.4 to 9.0) during 1995 to 2000, and subsequently stabilized.
  
  
  CONCLUSIONS
  Although uterine cancer mortality rates are declining in East Asia, additional effort is warranted to reduce the burden of gynecologic cancer in the future, through the implementation of early detection programs and the use of optimal therapeutic strategies.
authors.affiliation: Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Jung-Yun
authors.initials: JY
authors.lastname: Lee
authors.affiliation: Cancer Registration and Statistics Branch, National Cancer Center, Goyang, Korea.
authors.forename: Eun-Yang
authors.initials: EY
authors.lastname: Kim
authors.affiliation: Cancer Registration and Statistics Branch, National Cancer Center, Goyang, Korea.
authors.forename: Kyu-Won
authors.initials: KW
authors.lastname: Jung
authors.affiliation: Cancer Registration and Statistics Branch, National Cancer Center, Goyang, Korea. ; Molecular Epidemiology Branch, National Cancer Center, Goyang, Korea.
authors.forename: Aesun
authors.initials: A
authors.lastname: Shin
authors.affiliation: Department of Obstetrics and Gynecology, University of Hong Kong, Hong Kong.
authors.forename: Karen K L
authors.initials: KK
authors.lastname: Chan
authors.affiliation: Department of Obstetrics and Gynecology, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Aoki
authors.affiliation: Department of Obstetrics and Gynecology, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Jae-Weon
authors.initials: JW
authors.lastname: Kim
authors.affiliation: Department of Obstetrics and Gynecology, National University Hospital, Singapore.
authors.forename: Jeffrey J H
authors.initials: JJ
authors.lastname: Low
authors.affiliation: Cancer Registration and Statistics Branch, National Cancer Center, Goyang, Korea.
authors.forename: Young-Joo
authors.initials: YJ
authors.lastname: Won
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D016208:Databases, Factual; D005202:Asia, Eastern / Q000453:epidemiology; D005260:Female; D005833:Genital Neoplasms, Female / Q000401:mortality*; D006801:Humans; D008875:Middle Aged; D009026:Mortality / Q000639:trends; D010051:Ovarian Neoplasms / Q000401:mortality; D014594:Uterine Neoplasms / Q000401:mortality; D055815:Young Adult
keywords: Mortality; Ovarian neoplasms; Time trends; Uterine neoplasms