Uterine cervical adenocarcinomas and squamous carcinomas in Bombay: 1965-1990

To learn if the increased incidence of uterine cervical adenocarcinomas in developed populations exists in developing ones.

We studied age-adjusted (world) incidence rates of pathologic types of cervical cancer from 1965 through 1990 in the population-based Bombay Cancer Registry and in the National Cancer Registry's hospital-based frequencies of 1985-1987. The t-test was used to measure the statistical significance of change. International comparisons were made.

In Bombay, the incidence rates of adenocarcinoma per 10(6) women rose from 5.0 in 1965 to 12.9 in 1990 (p < 0.05). However, cervical cancers overall declined, from 244 per 10(6) in 1965 to 176 in 1990 (p < 0.001), squamous carcinomas declined from 167 to 129 per 10(6) (p < 0.05), other types of cervical cancers declined from 10.9 to 2.9 per 10(6) women (nsi and nonpathologically diagnosed cervical cancers declined from 61 to 31 per 10(6) (p < 0.05). Adenocarcinomas were 2.5% of all cervical cancers in Bombay's overall population in 1965, and were 7.0% in 1990; they were only 3.3% in 5 Indian hospital registries but were a higher percent in the Tata Hospital Bombay and internationally. The peak age of adenocarcinoma patients was 50-55 years in Bombay, unlike a younger peak age in the West, and 60-65 years for squamous carcinomas.

These Occidental-type trends might be due to increased awareness of cervical adenocarcinomas and/or changes associated with industrialization. Such trends might occur in other developing countries in the future. Greater awareness of cervical adenocarcinoma and its early diagnosis by endocervical brush cytology are needed in such populations.