Abstract
BackgroundCervical cancer continues to show a high burden among young women worldwide, particularly in low- and middle-income countries. Limited data is available describing cervical cancer mortality among young women in Latin America and the Caribbean (LAC). The purpose of this study was to examine the mortality trends of cervical cancer among young women in LAC and predict mortality rates to 2030.MethodsDeaths from cervical cancer were obtained from the World Health Organization mortality database. Age-standardized mortality rates per 100,000 women-years were estimated in women aged 20–44 years using the world standard population for 16 countries (and territories) in LAC from 1997 to 2017. We estimated the average mortality rates for the last 4 years (2014–2017). Joinpoint regression models were used to identify significant changes in mortality trends. Nordpred method was used for the prediction of the mortality rates to 2030.ResultsBetween 2014 and 2017, Paraguay and Venezuela had the highest mortality rates of cervical cancer, whereas Puerto Rico had the lowest rates. Overall, most of the LAC countries showed downward trends of cervical cancer mortality over the entire period. Significant decreases were observed in Chile (Average annual percent change [AAPC]: − 2.4%), Colombia (AAPC: − 2.0%), Cuba (AAPC: − 3.6%), El Salvador (AAPC: − 3.1%), Mexico (AAPC: − 3.9%), Nicaragua (AAPC: − 1.7%), Panama (AAPC: − 1.7%), and Peru (AAPC: − 2.2%). In contrast, Brazil (AAPC: + 0.8%) and Paraguay (AAPC: + 3.7%) showed significant upward trends. By 2030, mortality rates are not predicted to further decrease in some LAC countries, including Argentina, Paraguay, and Venezuela.ConclusionsMortality trends of cervical cancer among young women have large variability in LAC countries. Cervical cancer screening programs have a high priority for the region. Primary and secondary prevention in the community are necessary to accelerate a reduction of cervical cancer mortality by 2030.
Highlights
Cervical cancer continues to show a high burden among young women worldwide, in low- and middle-income countries
Where Δtot is the total change, Δrisk is the change in function of risk, Δpop is the change in function of the population, Nooo is the number of observed cases, Nfff is the number of projected cases, and Noff is the number of expected cases when the mortality rates increase during the observed period
Most countries showed a significant decrease in cervical cancer mortality from 1997 to 2017: Chile (AAPC: −2.4%; 95% CI: -3.7, -1.1), Colombia (AAPC: − 2.0%; 95% CI: − 2.6, − 1.4), Cuba (AAPC: − 3.6%; 95% CI: − 4.9, − 2.3), El Salvador (AAPC: − 3.1%; 95% CI: − 5.2, − 1.0), Mexico (AAPC: − 3.9%; 95% CI: − 4.6, − 3.3), Peru (AAPC: − 2.2%; 95% CI: − 3.5, − 0.9), Nicaragua (AAPC: − 1.7%; 95% CI: − 2.8, − 0.6) and Panama (AAPC: − 1.7%; 95% CI: − 3.2, − 0.2)
Summary
Cervical cancer continues to show a high burden among young women worldwide, in low- and middle-income countries. Cervical cancer remains a major public health problem in low- and middle-income countries (LMICs) [1,2,3]. Substantial declines in incidence rates have been observed worldwide, in European countries [4, 5], cervical cancer continues to affect disproportionately women in LAC compared with most other regions [6]. Due to the high burden of this disease, in 2020 the World Health Organization (WHO) adopted a global strategy to decrease the number of new cervical cancer cases, with the aim of maintaining an incidence rate below 4 per 100,000 women [7]. Despite advances in treatment in the LAC region, barriers to treatment access persist
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