Increasing trends in cervical cancer mortality among young Japanese women below the age of 50 years: an analysis using the Kanagawa population-based Cancer Registry, 1975-2012.
BACKGROUND
In Japan, cervical cancer (CC) deaths among women aged <50 years have doubled over the last three decades. Obtaining age-specific CC mortality rates among young women is important for taking measures against CC. Age-adjusted CC mortality rates for all ages are inadequate because of the classification of 'uterine cancer, not otherwise specified' (NOS uterine cancer) and CC mortality rates among elderly women. The aim of the present study was to calculate exact age-specific CC mortality rates in women aged <50 years in Kanagawa, taking into account the impact of NOS uterine cancer.


METHODS
Using the Kanagawa Cancer Registry, CC deaths (1975-2012) were analyzed and CC mortality rates (age-adjusted, 20-29, 30-49, and ≥50 years) were calculated. In addition, hospitals were surveyed to reclassify cases of NOS uterine cancer. After reclassification, chronological trends were also analyzed.


RESULTS
Age-specific CC mortality rates in Kanagawa and Japan overall showed increasing trends for ages 20-29 (P for trend<0.001) and 30-49 (P for trend<0.001). Rates of NOS uterine cancer death were significantly lower in Kanagawa than in Japan overall (P<0.05), except for patients aged <50 years in 2005-2009 (P=0.159).


CONCLUSIONS
The present study revealed concern for CC among Japanese women younger than 50 years. Well-organized CC screening and HPV vaccination should be provided to reduce CC mortality rates for these young women.
Department of Obstetrics, Gynecology and Molecular Reproductive Science, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004, Japan.
Yoko
Y
Motoki
Department of Epidemiology and Public Health, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa 236-0004, Japan.
Shunsaku
S
Mizushima
Department of Biostatics and Epidemiology, Yokohama City University Graduate School, Yokohama, Kanagawa 236-0004, Japan.
Masataka
M
Taguri
Department of Epidemiology and Public Health, Yokohama City University Graduate School of Medicine, Yokohama, Kanagawa 236-0004, Japan; Teikyo University Graduate School of Public Health, Itabashi, Tokyo 173-8605, Japan.
Kenzo
K
Takahashi
Department of Obstetrics, Gynecology and Molecular Reproductive Science, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004, Japan.
Ryoko
R
Asano
Department of Gynecology, Kanagawa Cancer Center, Yokohama, Kanagawa 241-8515, Japan.
Hisamori
H
Kato
Department of Obstetrics, Gynecology and Molecular Reproductive Science, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004, Japan.
Mikiko
M
Asai-Sato
Cancer Prevention and Cancer Control Division, Kanagawa Cancer Center Research Institute, Yokohama, Kanagawa 241-8515, Japan.
Kayoko
K
Katayama
Cancer Prevention and Cancer Control Division, Kanagawa Cancer Center Research Institute, Yokohama, Kanagawa 241-8515, Japan.
Naoyuki
N
Okamoto
Department of Obstetrics, Gynecology and Molecular Reproductive Science, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004, Japan.
Fumiki
F
Hirahara
Department of Obstetrics, Gynecology and Molecular Reproductive Science, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, Kanagawa 236-0004, Japan. Electronic address: emiyagi@med.yokohama-cu.ac.jp.
Etsuko
E
Miyagi
D000328:Adult; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008875:Middle Aged; D012042:Registries; D002583:Uterine Cervical Neoplasms / Q000401:mortality*; D055815:Young Adult
Adult; Cancer registries; Female; Japan; Mortality; Papanicolaou test; Papillomavirus vaccine; Uterine cervical neoplasm; Uterine neoplasm