최근 26년간 여성 생식기 암 발생 양상의 변화

Abstract

Objective : Our purpose was to evaluate the changing trends of the incidence and histopathology of female genital malignancies through the three time periods (1975-1984, 1985-1994 and 1995-2000) Methods : A retrospective review was carried out of all the female genital malignancies with the exception of trophoblastic disease which reported to the Keimyung University Dongsan Medical Center between 1975 and 2000. Results : For 26 years (1975-2000), 5,846 cases of the genital malignancies were registered. In the period from 1995 to 2000, the average frequency of cervical cancer was 73.5%, ovarian cancer followed with 15.6%, uterine corpus with 8.7%, vaginal cancer with 1.0%, vulvar cancer with 0.9%, tubal cancer with 0.1%. Third time period (1995-2000) comparing to others (1975-1984, 1985-1994), the frequency of cervical cancer was decreased (93.4% in 1975-1984, 86.0% in 1985-1994) and the incidence of corpus (1.6% in 1975-1984, 3.6% in 1985-1994) and ovarian cancer (2.4% in 1975-1984, 6.3% in 1985-1994) were increased. The most frequent histologic type of cervical cancer was squamous cell carcinoma, and followed by adenocarcinoma. Adenocarcinoma of the cervix showed a gradual increase in incidence (12.4% in 1995-2000, 5.0% in 1975-1984, 8.2% in 1985-1994). The peak age incidence of cervical cancer was noted between 40-49 years. Based on the FIGO staging system for cervical cancer, stage I was most frequent during last 6 years. According to invasiveness of the cervix, the frequency of cervical intraepithelial neoplasm was increased (62.8% in 1995-2000, 25.7% in 1975-1984, 38.4% in 1985-1994). Ovarian cancer was the second most common malignancy and gradually increased. The peak age was 50-59 years. According to histologic subtype, an epithelial ovarian tumor was most frequent. Corpus cancer was the third most common malignancy. The peak age was 50-59 years during the study period and endometrial cancer was most common. Conclusions : This study shows that the frequency of invasive cervical cancer was decreased whereas the incidence of endometrial cancer and ovarian cancer were increased. The frequency of cervical intraepithelial neoplasm was increased compared with invasive cervical cancer.

목적 : 계명의대 산부인과학교실에 내원한 환자를 대상으로 최근 26년간의 여성 암 발생 양상의 변화를 확인하고자 하였다. 연구 방법 : 1975년 1월부터 2000년 12월까지 계명의대 동산의료원 산부인과에 내원한 환자 중에서 융모성 질환을 제외한 여성 생식기 침윤암으로 조직 검사 결과 확진된 경우에 한하여 대상으로 하여 발생 빈도, 연령별 발생 분포, 병리조직학적인 소견에 따른 변화 등을 조사하였다. 1975년부터 1994년까지는 이미 발표한 자료를 이용하였다. 결과 : 전체 여성생식기 침윤암 중 자궁경부암의 분포는 전반기 10년간은 전체의 93.4%, 중반기 10년간은 86.0%, 후반기 6년간은 73.5%로 감소를 보였다. 자궁경부 종양 중 상피내종양은 전반기 10년간은 25.7%, 중반기 10년간은 38.4%, 후반기 6년간은 62.8%로 증가하는 양상을 보였고 편평상피암은 각각 70.6%, 56.6%, 31.7%로 감소하는 추세를 보였다. 연령별 분포는 전반기 10년과 후반기 6년간은 40-49세에 가장 많았으며, 중반기 10년간은 50-59세에 가장 많은 분포를 차지하였다. 난소암은 두 번째로 가장 많았으며 전반기 10년간은 2.4%, 중반기 10년간은 6.3%, 후반기 6년간은 15.6%로 점차 증가하는 양상이였다. 조직학적으로는 상피성 난소암이 가장 많았으며 연령별 분포는 전반기, 중반기, 후반기 모두 50-59세에 가장 많은 분포를 보였다. 자궁체부암은 주로 자궁내막암이었고 전반기 10년간은 1.6%, 중반기 10년간은 3.6%, 후반기 6년간은 8.7%로 증가 추세를 보였다. 연령별 분포는 50-59세에 가장 높은 분포를 보였다. 질암은 전반기, 중반기, 후반기 모두 1% 미만의 분포를 보였다. 결론 : 자궁경부암은 감소 추세에 있고 난소암과 자궁체부암은 증가 추세에 있다.