Abstract

BackgroundCervical cancer is the fourth most common cancer that occurs to women worldwide. This study aims to assess trends in incidence and mortality of cervical cancer in India and its states over past three decades for tracking the progress of strategies for the prevention and control of cervical cancer.MethodsData on cervical cancer incidence and mortality from 1990 to 2019 for India and its states were extracted from Global Burden of Disease study and were utilized for the analysis. Spatial and rank map has been used to see the changes in incidence and mortality of cervical cancer in different Indian states. Further, joinpoint regression analysis is applied to determine the magnitude of the time trends in the age standardized incidence and mortality rates of cervical cancer. We obtained the average annual percent change (AAPC) and corresponding 95% confidence intervals (CI) for each state.ResultsOverall, from 1990 to 2019 Jharkhand (Incidence: -50.22%; Mortality: -56.16%) recorded the highest percentage decrement in cervical cancer incidence and mortality followed by the Himachal Pradesh (Incidence: -48.34%; Mortality: -53.37%). Tamilnadu (1st rank), Jammu & Kashmir and Ladakh (32nd rank) maintained the same rank over the period of three decade for age standardized cervical cancer incidence and mortality. The regression model showed a significant declining trend in India between 1990 and 2019 for age standardized incidence rate (AAPC: −0.82; 95%CI: −1.39 to −0.25; p < 0.05) with highest decline in the period 1998-2005 (AAPC: −3.22; 95%CI: −3.83 to −2.59; p < 0.05). Similarly, a significant declining trend was observed in the age standardized mortality rate of India between 1990 and 2019(AAPC: −1.35; 95%CI: −1.96 to −0.75; p < 0.05) with highest decline in the period 1998-2005 (AAPC: −3.52; 95%CI: −4.17 to −2.86; p < 0.05).ConclusionThough the incidence and mortality of cervical cancer declined over past three decades but it is still a major public health problem in India. Information, education and communication activities for girls, boys, parents and community for the prevention and control of cervical cancer should be provided throughout the country.

Highlights

  • Cervical cancer is the fourth most common cancer that occurs to women worldwide

  • Joinpoint regression analysis has been applied to compute the magnitude of the time trends in the age-standardized incidence and mortality rates of Cervical Cancer, the Average Annual Percent Change (AAPC) and the corresponding 95% Confidence Interval (CI)

  • In this study, we found that there has been a significant decline in the incidence and mortality of cervical cancer over the past three decades in India; This corroborates with studies conducted by various others [16,17,18,19]

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Summary

Introduction

Cervical cancer is the fourth most common cancer that occurs to women worldwide. Cervical cancer is the fourth most common cancer in women [1]. Despite being a highly preventable cancer, in the year 2020, 604,127women were reported with cervical cancer, and 341,831women died from the disease globally [2]. Recent estimates for 2018 show that annually 569847 new cervical cancer cases were diagnosed worldwide. The age-standardized incidence and mortality rates are found to be 13.1 and 6.9 per 100,000 women [3]. These rates are quite higher among Indian women in comparison to global estimates. In India, the age-standardized incidence rate is 14.7 per 100,000 women, and the age-standardized mortality rate is 9.2 per 100,000 women [3]

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