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Hakkarainen J, Nevala A, Tomás E, Nieminen K, Malila N, Pitkäniemi J, Auranen A. Decreasing trend and changing indications of hysterectomy in Finland. Acta Obstet Gynecol Scand 2021; 100:1722-1729. [PMID: 33797081 DOI: 10.1111/aogs.14159] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Revised: 02/25/2021] [Accepted: 03/28/2021] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Hysterectomy has been one of the most common surgical procedures in women in Finland. We studied the population-based trends of hysterectomy and its indications from 1986 to 2017. MATERIAL AND METHODS A retrospective population-based cohort was created from the Care Register for Health Care by identifying women who had a hysterectomy from 1986 to 2017 and calculating the number of women from the Digital and Population Data Services Agency. We estimated the number and incidence of hysterectomy by period and age as well as by indication. We considered the primary diagnosis at the time of surgery as the indication of hysterectomy. RESULTS The number of hysterectomies increased from 7492 procedures in 1986 to 12 404 procedures in 1998, and reduced substantially after that to 5971 procedures in 2017, the turning point being in 1999. The incidence rate of hysterectomy has decreased on average by 2.5% annually from 432.6 per 100 000 women in 1998-2001 to 224.5 per 100 000 women in 2014-2017. The median age at the time of hysterectomy has increased from 51 years in 1998-2001 to 55 years in 2014-2017. The cumulative burden of hysterectomy by age of 60 years has nearly halved from the first 4-year period (23%) to the last (12%). After 2010, the most common indication has been genital prolapse and incontinence, whereas earlier it was uterine fibroids. CONCLUSIONS The number and incidence of hysterectomies have fluctuated during the observation period 1986-2017 and decreased considerably during the past 17 years in Finland. This is probably a result of the availability of hormonal and other conservative treatment options for bleeding disorders and uterine fibroids. As hysterectomy practically removes the risk for endometrial cancer, the change in hysterectomy incidence over time emphasizes the importance of correcting endometrial cancer incidence according to hysterectomy incidence.
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Affiliation(s)
- Jenni Hakkarainen
- Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland.,Faculty of Medicine and Health Technology (MET), Tampere University, Tampere, Finland.,Department of Obstetrics and Gynecology, Central Finland Central Hospital, Jyväskylä, Finland
| | - Aapeli Nevala
- Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland
| | - Eija Tomás
- Faculty of Medicine and Health Technology (MET), Tampere University, Tampere, Finland.,Department of Obstetrics and Gynecology, Tampere University Hospital, Tampere, Finland.,Tays Cancer center, Tampere University Hospital, Tampere, Finland
| | - Kari Nieminen
- Faculty of Medicine and Health Technology (MET), Tampere University, Tampere, Finland.,Department of Obstetrics and Gynecology, Tampere University Hospital, Tampere, Finland.,Tays Cancer center, Tampere University Hospital, Tampere, Finland
| | - Nea Malila
- Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland
| | - Janne Pitkäniemi
- Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland.,Department of Public Health, School of Medicine, University of Helsinki, Helsinki, Finland.,Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Annika Auranen
- Department of Obstetrics and Gynecology, Tampere University Hospital, Tampere, Finland.,Tays Cancer center, Tampere University Hospital, Tampere, Finland
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Mroueh R, Nevala A, Haapaniemi A, Pitkäniemi J, Salo T, Mäkitie AA. Risk of second primary cancer in oral squamous cell carcinoma. Head Neck 2020; 42:1848-1858. [PMID: 32057158 DOI: 10.1002/hed.26107] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 01/06/2020] [Accepted: 01/28/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND The incidence and survival of oral squamous cell carcinoma (OSCC) patients have increased in recent years. Understanding their long-term survival aspects is essential for optimal treatment and follow-up planning. Almost one in five cancers diagnosed occurs nowadays in individuals with a previous diagnosis of cancer. METHODS Patients diagnosed with primary OSCC during 1953-2015 were retrieved from the Finnish Cancer Registry. Both standardized incidence ratios (SIR) and excess absolute risk (EAR) per 1000 person-years at risk (PYR) of second primary cancer (SPC) were calculated relative to the general population. RESULTS Among 6602 first primary OSCC patients there were 640 (10%) SPCs. The SIR for SPCs was 1.85 (95% CI: 1.71-1.99, P < .001) corresponding to an EAR of 8.78 (95% CI: 7.29-10.26). CONCLUSIONS Health care professionals should be aware of the second primary cancer risk after management of primary OSCC and patients need to be counseled about this phenomenon.
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Affiliation(s)
- Rayan Mroueh
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Helsinki and HUS Helsinki University Hospital, Helsinki, Finland
| | | | - Aaro Haapaniemi
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Helsinki and HUS Helsinki University Hospital, Helsinki, Finland
| | - Janne Pitkäniemi
- Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer and Research, Helsinki, Finland.,Faculty of Social Sciences, University of Tampere, Tampere, Finland.,Department of Public Health, School of Medicine, University of Helsinki, Helsinki, Finland
| | - Tuula Salo
- Cancer and Translational Medicine Unit, University of Oulu, Medical Research Unit, Oulu University Hospital, Helsinki, Finland.,Oral and Maxillofacial Diseases, University of Helsinki, Helsinki, Finland.,Haartman Institute, University of Helsinki, Helsinki, Finland
| | - Antti A Mäkitie
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Helsinki and HUS Helsinki University Hospital, Helsinki, Finland.,Division of Ear, Nose and Throat Diseases, Department of Clinical Sciences, Intervention and Technology, Karolinska Institutet and Karolinska Hospital, Stockholm, Sweden.,Research Program in Systems Oncology, Faculty of Medicine, University of Helsinki, Helsinki, Finland
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