Global distribution, risk factors, and recent trends for cervical cancer: a worldwide country-level analysis

NCD Global Health Research Group, Association of Pacific Rim Universities (APRU), Junjie Huang, Yunyang Deng, Daniel Boakye, Man Sing Tin, Veeleah Lok, Lin Zhang, Don Eliseo Lucero-Prisno III, Wanghong Xu, Zhi-Jie Zheng, Edmar Elcarte, Mellissa Withers*, Martin C.S. Wong*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives
This study aimed to evaluate the most updated worldwide distribution, risk factors, and temporal trends of cervical cancer for different countries and age groups.

Methods
The Global Cancer Observatory database was retrieved for the age-standardized rates (ASRs, per 100,000 persons) for incidence and mortality of cervical cancer in 2018. The associations with risk factors were examined by multivariable regression analysis, adjusting for human development index (HDI) and gross domestic products (GDP) per capita. Joinpoint regression analysis was used to calculate the 10-year annual average percent change (AAPC) for incidence and mortality.

Results
A total of 568,847 new cases (ASR, 13.1) and 311,365 deaths (ASR, 6.9) of cervical cancer were reported globally in 2018. The highest incidence and mortality were observed in Southern Africa (ASRs, 43.1 and 20.0) and countries with low HDI (ASRs, 29.8 and 23.0). Countries with higher incidence and mortality had lower HDI (β = −8.19, 95% CI -11.32 to −5.06, p < 0.001; β = −7.66, CI -9.82 to −5.50; p < 0.001) but higher alcohol consumption (β = 1.89, 95% CI 0.59 to 3.19, p = 0.005; β = 0.98, CI 0.08 to 1.88; p = 0.033). An increasing trend of incidence was also observed in younger populations, with Cyprus (AAPC, 6.96), Sweden (AAPC, 4.88), and Norway (AAPC, 3.80) showing the most prominent.

Conclusions
The burden of cervical cancer was highest in regions with low and medium HDI and was associated with higher prevalence of alcohol consumption. There was an overall decreasing burden of cervical cancer; however, an increase in incidence and mortality was observed in some populations. More intensive preventive strategies are recommended for these populations.
Original languageEnglish
Pages (from-to)85-92
Number of pages8
JournalGynecologic Oncology
Volume164
Issue number1
Early online date17 Nov 2021
DOIs
Publication statusE-pub ahead of print - 17 Nov 2021

Keywords

  • cervical cancer
  • epidemiology
  • incidence
  • mortality
  • risk factors
  • trend

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