In Korea, cervical cancer is the fifth most common female cancer and the eighth most common

Transcription

1 Focused Issue of This Month Research on Uterine Cervical Cancer in Korea : Current Status and Perspectives JooHyun Nam, MD Department of Obstetrics and Gynecology, University of Ulsan College of Medicine jhnam@amc.seoul.kr J Korean Med Assoc 2007; 50(9): Abstract In Korea, cervical cancer is the fifth most common female cancer and the eighth most common cause of female cancer deaths. It is the most frequently diagnosed gynecologic cancer. Over the past decades, a marked reduction in the incidence and mortality of this malignancy has been documented. This has been largely attributed to widespread screening using papanicolaou smear, the early detection and treatment of preivasive lesions, and development of an effective treatment modality for invasive cervical cancer. The recently developed human papilomavirus vaccine is expected to further reduce the incidence and mortality of this malignancy markedly. Epidemiologic, biologic, and clinical research on cervical cancer is carried out worldwide to introduce human papillomavirus test and vaccine and to develop effective treatment for invasive cancer. At this point of time, the author reviewed the present status of research on cervical cancer and proposed future studies required to reduce the incidence and mortality of this malignancy in Korea. Keywords : Research; Cervical cancer; Current status; Perspectives 807

2 Nam JH Pancreas 2.3% Hematologic 2.5% Ovary 3.6% Liver 6.0% Lung 6.6% Others 17.6% Cervix uteri 9.1% Breast 16.8% Stomach 16.3% Colorectal 10.7% Thyroid 9.5% Others 17.1% Leukemia 2.7% Ovary 2.9% Cervix uteri 4.6% Pancreas 5.6% Breast 6.4% Gallbladder 6.7% Stomach 16.8% Liver 11.5% Colorectal 11.1% Lung 14.7% Figure 1. Left; frequency of female cancer in Korea (2002). Right; cause of female cancer death in Korea (2005). Cervical cancer is the fifth most common female cancer and the eighth most common cause of female cancer death in Korea. 808

3 Research on Cervical Cancer in Korea Proportion (%) Breast Cancer Stomach Cancer Colorectal Cancer Thyroid Cancer Cervical Cancer (including CIS) Years Number of cases Years Stomach Cancer Breast Cancer Cervical Cancer (including CIS) Cervical Cancer (excluding CIS) Colorectal Cancer Thyroid Cancer Figure 2. Upper; the proportion of each organ cancer cases among all cancer cases in Korea(1988~2002). Lower; the actual number of each organ cancer in Korea (1995~2002). The proportion of cervical cancer cases among all cancer cases reduced over the past 2 decades and the actual number of cervical cancer also reduced. 809

4 Nam JH Figure 3. The death rate for cervical cancer in Korea (1993~2002). 810

5 Research on Cervical Cancer in Korea 811

6 Nam JH 11. Minstry of Health and Welfare Annual report of Korea Central Cancer Registry. Seoul Korean Society of Obstetrics and Gynecology. Annual Report of Gynecologic Cancer Registry Program in Korea for 2004 (Jan. 1st, 2004Dec. 31st, 2004). Korean J Obstet Gynecol 2006; 49: Chung HH, Jang MJ, Jung KW, Won YJ, Shin HR, Kim JW, Lee HP. Cervical cancer incidence and survival in Korea: Int J Gynecol Cancer 2006; 16: Devesa SS, Young JL, Brinton LA, Fraumeni JF. Recent trends in cervix uteri cancer. Cancer 1989; 64: Eide TJ. Cancer of the uterine cervix in Norway by histologic type, J Natl Cancer Inst 1987; 79: Nieminen P, Kallio M, Hakama M. The effect of mass screening on incidence and mortality of squamous and adenocarcinoma of cervix uteri. Obstet Gynecol 1995; 85: Khang SK, Park SY. Guidelines for the screening of uterine cervical cancer. J Korean Med Assoc 2002; 45: Miller AB, Anderson G, Brisson J, Laidlaw J, Le Pitre N, Malcolmson P, Mirwaldt P, Stuart G, Sullivan W. Report of a National Workshop on Screening for Cancer of the Cervix. CMAJ 1991; 145: Sato S, Makino H, Yajima A, Fukao A. Cervical cancer screening in Japan. A casecontrol study. Acta Cytol 1997; 41: Patnick J. Cervical cancer screening in England. Eur J Cancer 812

7 Research on Cervical Cancer in Korea 2000; 36: Schaffer P, SanchoGarnier H, Fender M, Dellenbach P, Carbillet JP, Monnet E, Gauthier GP, Garnier A. Cervical cancer screening in France. Eur J Cancer 2000; 36: Schenck U, von Karsa L. Cervical cancer screening in Germany. Eur J Cancer 2000; 36: Segnan N, Ronco G, Ciatto S. Cervical cancer screening in Italy. Eur J Cancer 2000; 36: Nanda K, McCrory DC, Myers ER, Bastian LA, Hasselblad V, Hickey JD, Matchar DB. Accuracy of the Papanicolaou test in screening for and followup of cervical cytologic abnormalities: a systematic review. Ann Intern Med 2000; 132: Song MK, Kwon YI, Park TC, Chon MJ, Shin JW, Lee JW, Lee JM, Namkoong SE. False negative cytology in cervical smears: An evaluation of 186 cases of squamous intraepithelial lesion and squamous cell carcinoma, hitologically confirmed. Korean J Obstet Gynecol 2001; 44: Wright TC, Denny L, Kuhn L, Pollack A, Lorincz A. HPV DNA testing of selfcollected vaginal samples compared with cytologic screening to detect cervical cancer. JAMA 2000; 283: Schiffman M, Herrero R, Hildesheim A, Sherman ME, Bratti M, Wacholder S, Alfaro M, Hutchinson M, Morales J, Greenberg MD, Lorincz AT. HPV DNA testing in cervical cancer screening: results from women in a highrisk province of Costa Rica. JAMA 2000; 283: Kulasingam SL, Hughes JP, Kiviat NB, Mao C, Weiss NS, Kuypers JM, Koutsky LA. Evaluation of human papillomavirus testing in primary screening for cervical abnormalities: comparison of sensitivity, specificity, and frequency of referral. JAMA 2002; 288: Bollen LJ, Tjong AHSP, van der Velden J, Mol BW, Lammes FB, ten Kate FW, ter Schegget J, Bleker OP. Human papillomavirus DNA after treatment of cervical dysplasia: low prevalence in normal cytologic smears. Cancer 1996; 77: Elfgren K, Bistoletti P, Dillner L, Walboomers JM, Meijer CJ, Dillner J. Conization for cervical intraepithelial neoplasia is followed by disappearance of human papillomavirus deoxyribonucleic acid and a decline in serum and cervical mucus antibodies against human papillomavirus antigens. Am J Obstet Gynecol 1996; 174: Solomon D, Schiffman M, Tarone R. Comparison of three management strategies for patients with atypical squamous cells of undetermined significance: baseline results from a randomized trial. J Natl Cancer Inst 2001; 93: Manos MM, Kinney WK, Hurley LB, Sherman ME, Shieh Ngai J, Kurman RJ, Ransley JE, Fetterman BJ, Hartinger JS, McIntosh KM, Pawlick GF, Hiatt RA. Identifying women with cervical neoplasia: using human papillomavirus DNA testing for equivocal Papanicolaou results. JAMA 1999; 281: Kim JJ, Wright TC, Goldie SJ. Costeffectiveness of human papillomavirus DNA testing in the United Kingdom, The Netherlands, France, and Italy. J Natl Cancer Inst 2005; 97: Goldie SJ, Gaffikin L, GoldhaberFiebert JD, GordilloTobar A, Levin C, Mahe C, Wright TC. Costeffectiveness of cervical cancer screening in five developing countries. N Engl J Med 2005; 353: Shin HR, Lee DH, Herrero R, Smith JS, Vaccarella S, Hong SH, Jung KY, Kim HH, Park UD, Cha HS, Park S, Touze A, Munoz N, Snijders PJ, Meijer CJ, Coursaget P, Franceschi S. Prevalence of human papillomavirus infection in women in Busan, South Korea. Int J Cancer 2003; 103: Shin HR, Franceschi S, Vaccarella S, Roh JW, Ju YH, Oh JK, Kong HJ, Rha SH, Jung SI, Kim JI, Jung KY, van Doorn LJ, Quint W. Prevalence and determinants of genital infection with papillomavirus, in female and male university students in Busan, South Korea. J Infect Dis 2004; 190: Bosch FX. The Etiology of Squamous Cell Cervical Cancer. In: Rohan TE, Shah KV, ed. Cervical Cancer: From Etiology to Prevention. Dordrecht: Kluwer Academic Publishers, 2004: zur Hausen H. Human papillomaviruses and their possible role in squamous cell carcinomas. Curr Top Microbiol Immunol 1977; 78: IARC. Monographs on the Evaluation of Carcinogenic Risks to Humans. Human Papillomaviruses. Lyon. 1995; Villa LL, Costa RL, Petta CA, Andrade RP, Paavonen J, Iversen OE, Olsson SE, Hoye J, Steinwall M, RiisJohannessen G, AnderssonEllstrom A, Elfgren K, Krogh G, Lehtinen M, Malm C, Tamms GM, Giacoletti K, Lupinacci L, Railkar R, Taddeo FJ, Bryan J, Esser MT, Sings HL, Saah AJ, Barr E. High sustained efficacy of a prophylactic quadrivalent human papillomavirus types 6/11/16/18 L1 viruslike particle vaccine through 5 years of followup. Br J Cancer 2006; 95: Harper DM, Franco EL, Wheeler CM, Moscicki AB, Romanowski B, RoteliMartins CM, Jenkins D, Schuind A, Costa Clemens SA, Dubin G. Sustained efficacy up to 4.5 years of a bivalent L1 viruslike particle vaccine against human papillomavirus types 16 and 18: followup from a randomised control trial. Lancet 2006; 367: Landoni F, Maneo A, Colombo A, Placa F, Milani R, Perego P, Favini G, Ferri L, Mangioni C. Randomised study of radical surgery versus radiotherapy for stage IbIIa cervical cancer. Lancet 1997; 350: Delgado G, Bundy BN, Fowler WC, Stehman FB, Sevin B, Creasman WT, Major F, DiSaia P, Zaino R. A prospective surgical pathological study of stage I squamous carcinoma of 813

8 Nam JH the cervix: a Gynecologic Oncology Group Study. Gynecol Oncol 1989; 35: Nam JH, Kim JH, Kim DY, Kim MK, Yoo HJ, Kim YM, Kim YT, Mok JE. Comparative study of laparoscopicovaginal radical hysterectomy and abdominal radical hysterectomy in patients with early cervical cancer. Gynecol Oncol 2004; 92: Ryu HS, Kang SB, Kim KT, Chang KH, Kim JW, Kim JH. Efficacy of different types of treatment in FIGO stage IB2 cervical cancer in Korea: results of a multicenter retrospective Korean study(kgog1005). Int J Gynecol Cancer 2007; 17: NCI Clinical Announcement, US Dept. of Health and Human Services, Publinc Health Service, National Institutes of Health, February Chung HH, Lee S, Sim JS, Kim JY, Seo SS, Park SY, Roh JW. Pretreatment laparoscopic surgical staging in locally advanced cervical cancer: preliminary results in Korea. Gynecol Oncol 2005; 97: Peer Reviewer Commentary 814