Incidence and treatment outcomes of uterine cervical cancer in Korea 1999-2018 from the national cancer registry

Objective: To describe the incidence and survival outcomes of uterine cervical cancer during 1999-2018. Methods: Patients who were diagnosed with cervical cancer during 1999-2018 were identified in the Korea Central Cancer Registry. Age-standardized incidence rates (ASRs) and annual percent changes (APCs) were calculated. Survival rates by histology, year of diagnosis (1999-2008 vs. 2009-2018), stage, and age at diagnosis were analyzed. Results: The absolute incidence of cervical cancer decreased over 20 years from 4,488 in 1999 to 3,500 in 2018, with an APC of -3.42% (p<0.0001). While ASR of squamous cell carcinoma (SCCA) more than halved from 13.27 per 100,000 in 1999 to 6.16 in 2018 (APC, -4.04%), adenocarcinoma continued to rise (ASR, 1.30 per 100,000 to 1.92; APC, 1.52%; p<0.0001). Patients with adenocarcinoma were younger than those with SCCA (mean, 49.9 +/- 12.7 vs. 52.9 +/- 14.6 years; p<0.0001). Five-year survival rate of cervical cancer patients overall was 78.0%. Adenocarcinoma had poorer survival than SCCA (5-year survival rate, 76.8% vs. 79.8%; p<0.0001). There was no survival difference between patients who were diagnosed between 1999-2008 and 2009-2018. Earlier-stage disease had better survival (5-year survival rate for localized, regional, and distant disease, 90.0% vs. 69.9% vs. 26.5%; p<0.0001). Younger patients aged <50 years had better survival than those aged >= 50 years (87.1% vs. 69.8%; p<0.0001). Conclusion: The incidence of SCCA of the uterine cervix declined while adenocarcinoma continued to increase slowly but significantly from 1999 to 2018 in Korea. Adenocarcinoma was diagnosed at a younger age, but had poorer survival outcome than SCCA.

Automated summary

This study aimed to investigate the trends of uterine cervical cancer incidence and survival outcomes from 1999 to 2018. The results showed a decrease in the absolute incidence of cervical cancer, with a significant decline in squamous cell carcinoma and a slow increase in adenocarcinoma. Adenocarcinoma was diagnosed at a younger age but had worse survival outcomes compared to squamous cell carcinoma. Early-stage disease and younger age were associated with better survival rates.