@article{FERRIS2024151,
title = {Trends in uterine cancer incidence in the United States: The contribution of age, period and cohort effects},
journal = {Gynecologic Oncology},
volume = {187},
pages = {151-162},
year = {2024},
issn = {0090-8258},
doi = {https://doi.org/10.1016/j.ygyno.2024.04.026},
url = {https://www.sciencedirect.com/science/article/pii/S0090825824002117},
author = {Jennifer S. Ferris and Matthew T. Prest and Chin Hur and Ling Chen and Elena B. Elkin and Alex Melamed and Chung Yin Kong and Evan R. Myers and Laura J. Havrilesky and Stephanie V. Blank and William D. Hazelton and Jason D. Wright},
keywords = {Uterine cancer, Endometrial cancer, Age, Cohort, Period, Hysterectomy},
abstract = {Objective
In the U.S., uterine cancer incidence is rising, with racial and ethnic minorities experiencing the largest increases. We performed age-period-cohort analyses using novel methods to examine the contribution of age at diagnosis (age), year of diagnosis (period), and birth cohort (cohort), to trends in uterine cancer incidence.
Methods
We used uterine cancer incidence data from the Surveillance, Epidemiology, and End Result (SEER) 12 database (1992–2019), and performed hysterectomy-correction. We generated hexamaps to visualize age, period, and cohort effects, and used mutual information to estimate the percent contribution of age, period, and cohort effects, individually and combined, on uterine cancer incidence, overall and by race and ethnicity and histology.
Results
Hexamaps showed an increase in uterine cancer in later time periods, and a cohort effect around 1933 showing a lower incidence compared with earlier and later cohorts. Age, period, and cohort effects combined contributed 86.6% (95% CI: 86.4%, 86.9%) to the incidence. Age effects had the greatest contribution (65.1%, 95% CI: 64.3%, 65.9), followed by cohort (20.7%, 95% CI: 20.1%, 21.3%) and period (14.2%, 95% CI: 13.7%, 14.8%) effects. Hexamaps showed higher incidence in recent years for non-Hispanic Blacks and non-endometrioid tumors.
Conclusions
Age effects had the largest contribution to uterine cancer incidence, followed by cohort and period effects overall and across racial and ethnic groups and histologies.
Impact
These findings can inform uterine cancer modeling studies on the effects of interventions that target risk factors which may vary across age, period, or cohort.}
}