Increased incidence and improved survival in endometrioid endometrial cancer diagnosed since 1989 in the Netherlands: A population based study

Objectives: To measure progress against endometrioid endometrial carcinoma (EEC) in the Netherlands by analyzing trends in incidence, survival and mortality simultaneously. Study design: Descriptive study of incidence, survival and mortality rates of women with EEC in the Netherlands. Rates were age-standardized to the European standard population. Population-based data were extracted from the nationwide Dutch Cancer Registry (NCR) between 1989 and 2009. Mortality data since 1989 came from Statistics Netherlands. European age standardized incidence rates were calculated according to age, histology and stage. Five year relative survival estimates were calculated in four periods. Optimal progress against cancer is defined as decreasing incidence and/or improving survival accompanied by declining mortality. Results: 80% of the 32,332 patients newly diagnosed with a corpus uteri malignancy had an EEC. The incidence of EEC rose significantly from 11/100,000 to 15/100,000, being most pronounced in women with FIGO stage IB and in the group with grade 1&2 tumours (P < 0.05). Coinciding with the increased incidence, 5-year relative survival increased, especially for patients aged 60-74 years, in women with FIGO stage I, and in histology group grade 1&2, being 87%, 94% and 93%, respectively, during 2005-2009. Conclusion: The incidence of EEC (being 80% of corpus uteri cancer) increased markedly between 1989 and 2009, especially in women of 60-74 years. Five-year survival for patients with EEC increased from 83 to 85%. Progress against EEC has been less than was assumed previously, because mortality proportionally decreased only slightly, and because of the increasing incidence although survival improved.