Incidence, prevalence, mortality and survival trends in women with endometrial-, ovarian- and cervical cancer in the Nordic countries (1980-2023) with focus on younger women (0-49 years old).

Objective

Endometrial, ovarian, and cervical cancers predominantly affect middle-aged and older women, but temporal trends may differ in younger women due to distinct risk factors and clinical characteristics. We therefore assessed temporal trends in incidence, prevalence, mortality, and survival across these cancers in younger women.

Methods

Using population-based NORDCAN registry data, we identified women aged 0-49 years diagnosed with endometrial, ovarian, or cervical cancer in the Nordic countries between 1980 and 2023. Incidence, prevalence, mortality, and five-year relative survival (RS) were age-standardized, with the latter estimated using the Pohar-Perme method.

Results

Endometrial cancer incidence rates increased from 1.4 to 1.9 cases per 100,000 person-years (PY) between 1998 and 2000 and 2021-2023 (36% increase). Over the full study period, incidence rates declined for both ovarian cancer (4.2 to 2.1 cases per 100,000 PY; 50% decrease) and cervical cancer (6.5 to 5.5 cases per 100,000 PY; 15% decrease). Mortality rates decreased for women with ovarian cancer (1.9 to 0.6 per 100,000 PY; 75% decrease) and cervical cancer (1.5 to 0.5 per 100 00 PY; 67% decrease), while remaining steady at ≤ 0.2 per 100,000 PY for endometrial cancer. RS estimates remained high for endometrial cancer (90-95%). Cervical cancer five-year RS improved from 77-83% in 1979-1983 to 89-93% in 2019-2023, while ovarian cancer increased from 48 to 64% to 68-81%.

Conclusions

Gynecological cancers show distinct temporal trends among young women in the Nordic countries. These findings underscore the importance of age-specific prevention strategies, including obesity prevention, monitoring contraceptive trends, and continued implementation of HPV-based screening and vaccination.