Uterine cancer incidence statistics

Uterine (womb) cancer is the fourth most common cancer in females in the UK (2012), accounting for 5% of all new cases of cancer in females.[1-4]

In 2012, there were 8,617 new cases of uterine cancer in the UK.[1-4] The crude incidence rate Open a glossary item shows that there are 27 new uterine cancer cases for every 100,000 females in the UK.

The European age-standardised rates Open a glossary item (AS rates) do not differ significantly between the constituent countries of the UK.[1-4]

Uterine Cancer (C54-C55), Number of New Cases, Crude and European Age-Standardised (AS) Incidence Rates per 100,000 Population, UK, 2012

England Wales Scotland Northern Ireland UK
Cases 7,192 458 724 243 8,617
Crude Rate 26.5 29.3 26.5 26.2 26.6
AS Rate 28.5 28.8 26.9 30.5 28.4
AS Rate - 95% LCL 27.9 26.1 24.9 26.6 27.8
AS Rate - 95% UCL 29.2 31.4 28.9 34.3 29.0

95% LCL and 95% UCL are the 95% lower and upper  confidence limits around the AS rate Open a glossary item

ASR calculated with ESP2013. Not comparable with ASRs calculated with ESP1976.

In the 1990s there was a north-south divide in corpus uteri (ICD-10 C54) incidence rates across Great Britain, with higher rates in the midlands, south and east of England, and lower rates in Scotland and the north of England. The latest analyses of uterine cancer incidence rates across the former cancer networks throughout the UK reports significant variation with higher than average rates in Wales, Yorkshire, the Midlands and Anglia and lower than average rates in Scotland, the North West, and Southern England.[5,6]

References

  1. Data were provided by the Office for National Statistics on request, July 2014. Similar data can be found here: http://www.ons.gov.uk/ons/rel/vsob1/cancer-statistics-registrations--england--series-mb1-/index.html.
  2. Data were provided by ISD Scotland on request, April 2014. Similar data can be found here: http://www.isdscotland.org/Health-Topics/Cancer/Publications/index.asp.
  3. Data were provided by the Welsh Cancer Intelligence and Surveillance Unit on request, April 2014. Similar data can be found here: http://www.wales.nhs.uk/sites3/page.cfm?orgid=242&pid=59080.
  4. Data were provided by the Northern Ireland Cancer Registry on request, June 2014. Similar data can be found here: http://www.qub.ac.uk/research-centres/nicr/.
  5. National Cancer Intelligence Network (NCIN). Cancer Incidence and Mortality by Cancer Network, UK, 2005. London: NCIN; 2008.
  6. National Cancer Intelligence Network (NCIN). Cancer e-Atlas. Accessed January 2014.
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Uterine cancer incidence is related to age, but does not entirely follow the pattern of increasing incidence with age seen for most cancers. In the UK between 2010 and 2012, an average of 26% of cases were diagnosed in women aged 75 and over. Almost three quarters (73%) of cases were diagnosed women aged between 40 and 74.[1-4]

Age-specific incidence rates rise sharply from around age 40, peak in the 70-74 age group, and subsequently drop. Changes in hormone levels, both endogenous and exogenous, during and after the menopause may explain the decrease in the oldest age groups.[5]

Uterine Cancer (C54-C55), Average Number of New Cases per Year and Age-Specific Incidence Rates per 100,000 Population, Females, UK, 2010-2012

ASR calculated with ESP2013. Not comparable with ASRs calculated with ESP1976.

References

  1. Data were provided by the Office for National Statistics on request, July 2014. Similar data can be found here: http://www.ons.gov.uk/ons/rel/vsob1/cancer-statistics-registrations--england--series-mb1-/index.html.
  2. Data were provided by ISD Scotland on request, April 2014. Similar data can be found here: http://www.isdscotland.org/Health-Topics/Cancer/Publications/index.asp.
  3. Data were provided by the Welsh Cancer Intelligence and Surveillance Unit on request, April 2014. Similar data can be found here:http://www.wales.nhs.uk/sites3/page.cfm?orgid=242&pid=59080.
  4. Data were provided by the Northern Ireland Cancer Registry on request, June 2014. Similar data can be found here: http://www.qub.ac.uk/research-centres/nicr/.
  5. Key TJ, Pike MC. The dose-effect relationship between 'unopposed' oestrogens and endometrial mitotic rate: its central role in explaining and predicting endometrial cancer risk. Br J Cancer 1988;57(2):205-12.
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Uterine cancer incidence rates have increased overall in Great Britain since the late-1970s, however most of this increase has occurred since the early 1990s.[1-3] European age-standardised Open a glossary item (AS) incidence rates remained stable between 1979-1981 and 1989-1991, then increased by 57% between 1989-1991 and 2010-2012. There are likely to be several reasons for the increase in incidence, including increased prevalence of overweight and obesity, and changes in reproductive behaviour.[4,5]

Uterine Cancer (C54-C55), European Age-Standardised Incidence Rates per 100,000 Population, Females, Great Britain, 1979-2012

ASR calculated with ESP2013. Not comparable with ASRs calculated with ESP1976.
 

Over the last decade (between 2001-2003 and 2010-2012), the European AS incidence rates have increased by 24%.[1-3,6]

Uterine Cancer (C54-C55), European Age-Standardised Incidence Rates per 100,000 Population, Females, UK, 1993-2012

ASR calculated with ESP2013. Not comparable with ASRs calculated with ESP1976.
 

Uterine cancer incidence rates have increased overall for most of the broad age groups in Great Britain since the late-1970s, with fast increases since the early 1990s, Rates in females aged 25-49 have overall remained relatively stable, though this includes a decrease followed by an increase since the late-1990s.[1-3]

The largest increase overall has been in women aged 70-79, with European AS incidence rates Open a glossary item doubling (101% increase) between 1979-1981 and 2010-2012. Rates also increased in women aged 60-69 and 80+ between 1979-1981 and 2010-2012 (88% and 52% increases, respectively).[1,3]

Increased obesity prevalence is probably implicated in rising uterine cancer rates in all age groups.[7,8] Use of hormone replacement therapy (HRT) Open a glossary item, particularly oestrogen-only forms, may explain the larger increases in older birth cohorts, oestrogen-only HRT was popular during the 1960s and early 1970s, but HRT overall is now used much less because it is associated with increased uterine cancer risk.[9-11] The impact of decreased HRT is perhaps yet to be seen in younger birth cohort, the decrease in uterine cancer rates until the 1990s in these younger birth cohorts may reflect the protective effect of oral contraceptives Open a glossary item, which have been in widespread use since the 1960s.[10-12]

Uterine Cancer (C54-C55), European Age-Standardised Incidence Rates per 100,000 Population, Females, By Age, Great Britain, 1979-2012

ASR calculated with ESP2013. Not comparable with ASRs calculated with ESP1976.

References

  1. Data were provided by the Office for National Statistics on request, July 2014. Similar data can be found here: http://www.ons.gov.uk/ons/rel/vsob1/cancer-statistics-registrations--england--series-mb1-/index.html.
  2. Data were provided by ISD Scotland on request, April 2014. Similar data can be found here: http://www.isdscotland.org/Health-Topics/Cancer/Publications/index.asp.
  3. Data were provided by the Welsh Cancer Intelligence and Surveillance Unit on request, April 2014. Similar data can be found here:http://www.wales.nhs.uk/sites3/page.cfm?orgid=242&pid=59080.
  4. Evans T, Sany O, Pearmain P, et al. Differential trends in the rising incidence of endometrial cancer by type: data from a UK population-based registry from 1994 to 2006. Br J cancer 2011;104(9):1505-1510.
  5. Duncan ME, Seagroatt V, Goldacre MJ. Cancer of the body of the uterus: trends in mortality and incidence in England, 1985–2008. BJOG 2012;119(3):333-339.
  6. Data were provided by the Northern Ireland Cancer Registry on request, June 2014. Similar data can be found here: http://www.qub.ac.uk/research-centres/nicr/.
  7. Bray F, Dos Santos Silva I, Moller H, et al. Endometrial cancer incidence trends in Europe: underlying determinants and prospects for prevention. Cancer Epidemiol Biomarkers Prev 2005;14(5):1132-42.
  8. National Cancer Intelligence Network (NCIN). Uterine Cancer in the United Kingdom: overall trends and variation by age. London: NCIN; 2013.
  9. Cogliano VJ, Baan R, Straif K, et al. Preventable Exposures Associated With Human Cancers. J Natl Cancer I 2011;103(24):1827-39.
  10. Bray F, Dos Santos Silva I, Moller H, et al. Endometrial cancer incidence trends in Europe: underlying determinants and prospects for prevention. Cancer Epidemiol Biomarkers Prev 2005;14(5):1132-42.
  11. Dossus L, Allen N, Kaaks R, et al. Reproductive risk factors and endometrial cancer: The European prospective investigation into cancer and nutrition. Int J Cancer 2009;127(2):442-51.
  12. Martin RM, Wheeler BW, Metcalfe C, et al. What was the immediate impact on population health of the recent fall in hormone replacement therapy prescribing in England? Ecological study. J Public Health 2010;32(4):555-64.
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Staging completeness for uterine cancer is high in England, with 91% of uterine cancers recorded with a known stage at diagnosis in 2013.[1]

Uterine Cancer (C54), Proportion of Cases Diagnosed at Each Stage, England 2013

[graph:inc_stage_uterine]

Females diagnosed with uterine cancer with a known stage most commonly present at stage I (74%), in England. More females with a known stage are diagnosed at an early stage (82% diagnosed at stage I or II) than an advanced stage (18% diagnosed at stage III or IV). More than 1 in 20 (7%) Females have metastases Open a glossary item at diagnosis (stage IV).[1]

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Most uterine cancer cases occur in the endometrium Open a glossary item, with much smaller proportions in the myometrium, fundus uteri and isthmus uteri (2010-2012).[1-4]

A small proportion of cases did not have the specific part of the uterus recorded in cancer registry data, or overlapped more than one part.[1-4]

Uterine Cancer (C54-C55), Percentage Distribution of Cases Diagnosed By Anatomical Site, UK, 2010-2012

Cancer site (ICD-10 code) Average Cases %
Isthmus Uteri (C54.0) 5 0.1%
Endometrium (C54.1) 7,969 93.8%
Myometrium (C54.2) 31 0.4%
Fundus Uteri (C54.3) 18 0.2%
Uterus, Overlapping and Unspecified (C54.9-C55) 470 5.5%
Total 8,494 100.0%

Cases and percentages may not sum due to rounding

References

  1. Data were provided by the Office for National Statistics on request, July 2014. Similar data can be found here: http://www.ons.gov.uk/ons/rel/vsob1/cancer-statistics-registrations--england--series-mb1-/index.html.
  2. Data were provided by ISD Scotland on request, April 2014. Similar data can be found here: http://www.isdscotland.org/Health-Topics/Cancer/Publications/index.asp.
  3. Data were provided by the Welsh Cancer Intelligence and Surveillance Unit on request, April 2014. Similar data can be found here: http://www.wales.nhs.uk/sites3/page.cfm?orgid=242&pid=59080.
  4. Data were provided by the Northern Ireland Cancer Registry on request, June 2014. Similar data can be found here: http://www.qub.ac.uk/research-centres/nicr/CancerInformation/.
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The lifetime risk of developing uterine cancer is 1 in 41 for women, in 2012 in the UK.[1]

The lifetime risk for uterine cancer has been calculated on the assumption that the possibility of having more than one diagnosis of uterine cancer over the course of a lifetime is very low (‘Current Probability’ method).[2]

References

  1. Lifetime risk estimates calculated by the Statistical Information Team at Cancer Research UK. Based on data provided by the Office of National Statistics, ISD Scotland, the Welsh Cancer Intelligence and Surveillance Unit and the Northern Ireland Cancer Registry, on request, December 2013 to July 2014.
  2. Esteve J, Benhamou E and Raymond L. Descriptive epidemiology. IARC Scientific Publications No.128, Lyon, International Agency for Research on Cancer, pp 67-68 1994.
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Uterine cancer (C54 only) is the fourth most common cancer in Europe for females, and the tenth most common cancer overall, with around 99,000 new cases diagnosed in 2012 (6% of female cases and 3% of the total). In Europe (2012), the highest World age-standardised Open a glossary item incidence rates for uterine cancer are in Macedonia; the lowest are in Greece. UK uterine cancer incidence rates are estimated to be the 20th highest in Europe.[1] These data are broadly in line with Europe-specific data available elsewhere.[2]

Uterine cancer (C54 only) is the sixth most common cancer worldwide for females, and the 14th most common cancer overall, with more than 319,000 new cases diagnosed in 2012 (5% of female cases and 2% of the total). Uterine cancer incidence rates are highest in Northern America, and lowest in South Central Asia, but this partly reflects varying data quality worldwide.[1]

Variation between countries may reflect different prevalence of risk factors, use of screening, and diagnostic methods.

References

  1. Ferlay J, Steliarova-Foucher E, Lortet-Tieulent J, et al.Cancer incidence and mortality patterns in Europe: Estimates for 40 countries in 2012. European Journal of Cancer (2013) 49, 1374-1403.
  2. Ferlay J, Soerjomataram I, Ervik M, et al. GLOBOCAN 2012 v1.0, Cancer Incidence and Mortality Worldwide: IARC CancerBase No. 11 [Internet]. Lyon, France: International Agency for Research on Cancer; 2013. Available from:http://globocan.iarc.fr, accessed December 2013.
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Age-standardised rates Open a glossary item for White females with uterine (womb) cancer range from 16.9 to 17.7 per 100,000. Rates for Asian and Black females are similar ranging from 10.7 to 18.0 per 100,000 and 13.7 to 23.6 per 100,000 respectively.[1] There appears to be no significant variation in uterine (womb) cancer incidence by ethnicity in the UK.

Ranges are given because of the analysis methodology used to account for missing and unknown data. For uterine (womb) cancer, 27,680 cases were identified; 22% had no known ethnicity.

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Prevalence refers to the number of people who have previously received a diagnosis of cancer and who are still alive at a given time point. Some patients will have been cured of their disease and others will not.

In the UK around 38,700 women were still alive at the end of 2006, up to ten years after being diagnosed with uterine cancer.[1]

Uterine Cancer (C54-C55), One, Five and Ten Year Cancer Prevalence, UK, 31st December 2006

1 Year Prevalence 5 Year Prevalence 10 Year Prevalence
Female 5,920 23,364 38,667

Worldwide, it is estimated that there were nearly 1.10 million women still alive in 2008, up to five years after their diagnosis.[2]

References

  1. National Cancer Intelligence Network (NCIN). One, Five and Ten Year Cancer Prevalence by Cancer Network, UK, 2006. London: NCIN; 2010.
  2. Ferlay J, Shin HR, Bray F, et al. GLOBOCAN 2008 v1.2, Cancer Incidence and Mortality Worldwide. IARC CancerBase No.10 [Internet]. Lyon, France: International Agency for Research on Cancer. 2010. Available from http://globocan.iarc.fr. Accessed May 2011.
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