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Running the Numbers

This analysis used data on gynecologic cancers among women in North Carolina obtained from the North Carolina Central Cancer Registry (NCCCR). The NCCCR collects, processes, and analyzes data on all cancer cases diagnosed among North Carolina residents. All health care providers who diagnose or treat cancer are required to report cases to the NCCCR within 6 months of diagnosis. To examine trends in incidence and mortality, annual incidence and mortality rates were calculated for gynecologic cancers among women in North Carolina (age-adjusted to the 2000 US standard population) for the years 1995 through 2011 (the most recent year for which complete incidence data were available). According to the Centers for Disease Control and Prevention (CDC), there are 5 main types of gynecologic cancers: cervical, uterine, ovarian, vaginal, and vulvar. The cancer site groupings were defined according to site recode variables from the Surveillance, Epidemiology, and End Results (SEER) Program of the National Cancer Institute [1]. When calculating rates for minority women, we included all races other than white. These cancers do not include in-situ cases. Cervical Cancer Cervical cancer, which is primarily caused by human papillomavirus (HPV) infection, can be prevented through regular Papanicoloau (Pap) smear screenings and use of the recently developed HPV vaccine [2]. The incidence rate of cervical cancer among all women in North Carolina decreased slightly between 1995 and 2011, from 9.4 to 7.3 cases per 100,000 women (Figure 1). During that same period, the rate of mortality from cervical cancer also decreased, from 3.6 to