A129
Trends in incidence of endometrial cancer in the West Midlands: 2000-2006
Omar Sany1, Sudha Sundar1, Philippa Pearmain2, Tim Evans2
1Pan-Birmingham Gynae Cancer Centre, City Hospital NHS, Birmingham, UK, 2West Midlands Cancer Intelligence Unit, Birmingham, UK
Background
Endometrial cancer is the most common female genital tract malignancy in the UK, with a 25% rise in incidence over the last decade to 6,891 women in 2006, largely attributed to increasing obesity. Two histological types of endometrial cancer are known - Type 1 endometrial cancer is oestrogen-driven, strongly linked to obesity, of endometroid histology and associated with good prognosis. Type 2 is non-oestrogen dependent, independent of obesity and is more aggressive. However, the histological distribution of this increase in incidence is not known. We investigated if the increase was seen mainly in Type 1 or Type 2 cancers and whether this varied with socioeconomic distribution.
Method
Data on histology and demographics were collated from 3444 women with endometrial cancer in the West Midlands Cancer Intelligence Unit registry during 2000-2006. 233 entries which did not conform to either Type 1 or Type 2 histology were excluded. Trends in incidence of endometrial cancer was analysed according to histological type and socioeconomic status (Index Deprivation quintiles).
Results
An increase in both endometrial cancers types was noted. However the ratio between the two histological types was relatively constant; 269 Type 1 : 44 Type 2 in 2000 to 547 Type 1: 87 Type 2 in 2006 (85.9% Type 1: 14.1% Type 2 in 2000 to 86.3% Type I : 13.7% Type 2 in 2006), p=0.96. No differences in the ratio were observed between the most affluent or least affluent socioeconomic class (p=0.98)
Conclusion
Contrary to general belief, the increase in incidence in endometrial cancer is seen in both oestrogen dependent and independent cancers. This is seen even in the least affluent population where obesity is more prevalent. Strategies to treat endometrial cancer and the deprivation gap in survival will need to target the increase in aggressive cancers in the least affluent population.
