The Decreasing Incidence of Endometrial Cancer: Public Health Implications

the increased risk of endometrial cancer has been docu- mented in several studies,4’7-‘6, … TABLE 1-Number of New Cases of Endometrial Cancer among …

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The Decreasing Incidence of Endometrial Cancer: Public Health Implications
Abstract: The incidence of endometrial cancer in the San Francisco area between 1969 and 1979 is compared to trends in estrogen sales and prescriptions. Both estrogen use and endometrial cancer incidence increased steadily until 1975 and then decreased significantly. The data support the previously documented association between endometrial cancer and estrogen use, but suggest that short-term usage may carry only slightly increased risk which can be eliminated entirely upon termination of therapy. (Am J Public Health 1982; 72:65-68.)
In 1978 we reported that the incidence of endometrial cancer had increased significantly in the San Francisco Bay Area between 1969 and 1975.1.2 The increase was limited to White women between the ages of 50 and 74 and it was suggested that the increased incidence was due to estrogen replacement therapy prescribed for post-menopausal women. The Bay Area rates of invasive endometrial cancer among this group doubled in six years, increasing from 102.7/100,000 in 1969 to 201.7 in 1975. A similar trend occurred simultaneously in several parts of the United States.3 The rates of endometrial cancer increased in all five of the San Francisco Bay Area counties, increased proportionally in each stage and histologic category, and were strongly associated with socioeconomic status. Data from Alameda County suggested that the incidence increase actually began in the mid-1960s and continued steadily for 10 years. Recent data show that the incidence peaked in 1975 and then decreased significantly, a pattern which correlates closely to that reported for national prescriptions of conjugated estrogens by researchers at the Food and Drug Administration.4 Our report presents the most recent data on the incidence of endometrial cancer in the San Francisco Bay Area and compares these data with trends in estrogen use over the corresponding time period.

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