Cervical Cancer Incidence Rates Research Articles

Secular trends in incidence and mortality of cervical cancer in India and its states, 1990-2019: data from the Global Burden of Disease 2019 Study

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.

Understanding cervical cancer after the age of routine screening: Characteristics of cases, treatment, and survival in the United States

ObjectiveGiven that cervical cancer incidence rates do not decline in women >65, there is generally limited screening, and these women have a poor prognosis, it is imperative to better understand this population. We aim to describe the characteristics, treatment, and survival of women >65 diagnosed with cervical cancer. MethodsSEER-Medicare 2004–2013 data was used to describe 2274 patients >65 diagnosed with cervical cancer. Five-year cancer-specific survival was estimated using the Kaplan-Meier method. Multivariable Poisson and Cox regression analyses identified characteristics associated with treatment and mortality. ResultsThe median age was 76.1 years, with nearly one-third of cases occurring in women >80 years. Most patients were non-Hispanic White (64.8%), had comorbidity scores ≥ 1 (53.9%) and squamous histology (66.3%). Most women were diagnosed at stage II or higher (62.7%), including nearly one-quarter at Stage IV (23.1%). Nearly 15% of patients were not treated (14.6%). Lack of treatment was associated with oldest age (>80), comorbidity scores ≥3, and stage IV disease. Five-year cancer-specific survival was 50%. Increasing age and stage at diagnosis were significantly associated with lower cancer-specific survival whereas treatment was strongly associated with increased survival. ConclusionMost women >65 with cervical cancer are diagnosed with locally advanced or metastatic disease and many do not receive treatment. Survival is improved with early-stage diagnosis and treatment. These findings, coupled with the fact that women >65 constitute an increasing proportion of the population, highlight the need to re-evaluate screening and treatment practices in this population to detect cervical cancer at earlier stages and increase survival. Novelty and impact statementIn SEER-Medicare linked data from 2004 to 2013, most women >65 with cervical cancer were diagnosed with locally advanced or metastatic disease. Both receipt of treatment and survival decreased with increasing age. These findings, coupled with the fact that women aged >65 constitute an increasing proportion of the population, highlight the need to re-evaluate screening and treatment practices in older women to detect cervical cancer at earlier stages and increase survival.

Trends in the Incidence Rates of Breast and Gynecological Cancers in Asia from 1998-2012: An Ecological Study.

There is limited evidence on the epidemiology and time trend analysis of incidence rates of gynecological cancer in Asia as a whole. We conducted this study to demonstrate breast and gynecological cancers incidence and trends in selected Asian populations. We conducted this ecological study using cancer and population data from cancer incidence in five continents (CI5). We extracted the data of breast, uterine, cervix and ovary cancers in selected Asian populations from 1998 to 2012 from CI5plus. We used Joinpoint regression model (version 4.8.0.1) to evaluate the annual percentage change (APC), which characterizes trends in cancer rates over time, and the average annual percent changes (AAPCs), which describes the average APCs over a period of multiple years. Results were considered statistically significant at P < 0.05. Between breast and gynecological cancers, breast cancer has the highest incidence rates among women in Asia. The time trend of the incidence rates showed a constant growth in breast, ovary and corpus uteri cancers. This rising trend was obviously sharper for uterine cancer (AAPC 95% CI = 3.4 [3.0, 3.7]) followed by breast [AAPC 95% CI = 2.1 (2.0, 2.2)] and ovarian cancers (AAPC 95% CI = 0.5 [-0.4, 1.3]). The age-adjusted incidence rate (ASR) of cervical cancer displayed a declining trend from 1998 to 2012 (AAPC 95% CI = -1.4 [-2.4, -0.5]). Incidence rates of breast and gynecological cancers have a rising trend in Asian countries. However, breast and gynecological cancers have different patterns of time trend.

Understanding facilitators and barriers to follow-up after abnormal cervical cancer screening examination among women living in remote areas of Romania: a qualitative study protocol

IntroductionIn 2020 in Europe, Romania had the second highest incidence and mortality rates of cervical cancer, after Montenegro. To address cervical cancer in the country, the Romanian government established a...

Reasons behind Low Cervical Screening Uptake among South Asian Immigrant Women: A Qualitative Exploration.

Despite advancements in prevention strategies, cervical cancer remains a leading cause of death among underprivileged women. Although Australia has low age-standardized cervical cancer incidence rates compared with other countries, disparities exist in cervical screening uptake among certain population subgroups, especially those from culturally and linguistically diverse (CALD) backgrounds. South Asian immigrant women have been reported to have lower cervical screening uptake than Australian-born women and those from other immigrant backgrounds. The objective of this study was to gain insight into the reasons and barriers for low cervical screening participation among South Asian immigrant women, through qualitative exploration. Semi-structured, in-depth interviews were conducted with 20 women, aged 26–50 years, living in Queensland, Australia, who were recruited via purposive sampling. After translation and transcription of recorded interviews, data was analysed via inductive thematic approach. Resulting themes, illustrating barriers towards screening, included: lack of cervical cancer and screening knowledge, especially of the changes in the revised screening program; effect of preventive, health-seeking behaviours; health care system factors; role of practical constraints and influence of sociocultural beliefs. Results suggest that culturally informed interventions, that involve relevant information provision and behavioural change strategies, to clarify women’s misconceptions, are required.

Assessment of ESGO Quality Indicators in Cervical Cancer Surgery: A Real-World Study in a High-Volume Chinese Hospital.

The ESGO developed a list of fifteen quality indicators for cervical cancer surgery in order to audit and improve clinical practice in 2020. However, data from the developing countries with high incidence rates of cervical cancer is still lacking. Therefore, we conducted a retrospective study of 7081 cases diagnosed as cervical cancer between 2014 and 2019 in a Chinese single center according to the quality indicators proposed by ESGO. A total of 5952 patients underwent radical procedures, with an average of 992.0 per year. All surgeries were performed or supervised by a certified gynecologic oncologist as surgical qualification grading system has been established. Compared with the low-volume group, patients in the high-volume group (≥15 cases/year) had a shorter hospital stay (P<0.001), more free surgical margins (P=0.031), and less complications (P<0.001), but the 5-year recurrence-free survival and overall survival rates were similar (P>0.05). Treatment was not planned at a multidisciplinary team meeting but with the consultation system. The required preoperative workup was incomplete in 19.7% of patients with pelvic MRI and 45.7% of patients with PET-CT. A total of 1459 (20.6%) patients experienced at least one complication after surgery. The CDC grade IIIb or higher complications occurred in 80 patients, accounting for 5.5% complications. The urological fistula rate within 30 postoperative days were 0.3%. After primary surgical treatment, 97.4% patients had clear vaginal and parametrial margins. After restaging FIGO 2009 to FIGO 2018 system, 14.7% patients with a stage T1b disease were T-upstaged. After a median follow-up of 42 months, recurrence occurred in 448 patients, and 82.1% patients recurred within 2 years. The 2-year RFS rate of patients with pT1b1N0 was 97.3% in 2009 FIGO staging system. Lymph node staging was performed in 99.0% patients with a stage T1 disease. After a primary surgical treatment for a stage pT1b1N0 disease, 28.3% patients received adjuvant chemoradiotherapy. Above all, most of quality indicators reached the targets, except four quality indicators. The quality indicators of ESGO should be popularized and applied in China to guarantee quality of surgery.

Knowledge, Attitude, and Practice (KAP) toward Cervical Cancer Screening among Adama Science and Technology University Female Students, Ethiopia.

Background Cervical cancer is a complication of Human Papillomavirus (HPV) infection is the second most common cancer in women worldwide. Eighty percent of the cases occur in low-resource countries. According to the 2009 World Health Organization report, the age-adjusted incidence rate of cervical cancer in Ethiopia was 35.9 per 100,000 patients with 7619 annual number of new cases and 60-81 deaths every year. The study is aimed at assessing the level of knowledge, attitude, and practice concerning cervical cancer among female students at Adama Science and Technology University. Methodology. An institutional based cross-sectional study was conducted among 667Adama Science and Technology University female students. A simple random sampling method was used to select the respondents. Structured self-administered questionnaire was used for data collection. Results About 404 (60.6%) of the participants heard about cervical cancer, 478 (71.7%) had positive attitude towards cervical cancer screening, and only 15 (2.2%) participants were screened for cervical cancer. Lack of information about cervical cancer was the most reported reason for not attending to cervical cancer screening. Conclusion and Recommendation. The study showed that there was low knowledge on cervical cancer and screening for premalignant lesion among women. There is a need to promote and encourage women to early cervical cancer screening at precancerous stage by informing their susceptibility to cervical cancer.

Roles of extended human papillomavirus genotyping and multiple infections in early detection of cervical precancer and cancer and HPV vaccination

BackgroundThe aim of the study was to investigate the risk of human papillomavirus (HPV) genotyping particularly vaccine genotypes and multiple infections for cervical precancer and cancer, which might contribute to developing genotype-specific screening strategy and assessing potential effects of HPV vaccine.MethodsThe HPV genotypes were identified using the Seq HPV assay on self-collected samples. Hierarchical ranking of each genotype was performed according to positive predictive value (PPV) for cervical intraepithelial neoplasia 2/3 or worse (CIN2+/CIN3+). Multivariate logistic regression model was used to estimate the odds ratios (ORs) with 95% confidence interval (CI) of CIN2+ according to multiplicity of types and vaccine types.ResultsA total of 2811 HPV-positive women were analyzed. The five dominant HPV genotypes in high-grade lesions were 16/58/52/33/18. The overall ranking orders were HPV16/33/35/58/31/68/18/ 56/52/66/51/59/45/39 for CIN2+ and HPV16/33/31/58/45/66/52/18/35/56/51/68/59/39 for CIN3+. The risks of single infection versus co-infections with other types lower in the hierarchy having CIN2+ were not statistically significant for HPV16 (multiple infection vs. single infection: OR = 0.8, 95%CI = 0.6-1.1, P = 0.144) or other genotypes (P > 0.0036) after conservative Bonferroni correction. Whether HPV16 was present or not, the risks of single infection versus multiple infection with any number (2, ≥2, or ≥ 3) of types for CIN2+ were not significantly different. In addition, HPV31/33/45/52/58 covered by nonavalent vaccine added 27.5% of CIN2, 23.0% of CIN3, and 12.5% of cancer to the HPV16/18 genotyping. These genotype-groups were at significantly higher risks than genotypes not covered by nonavalent vaccine. Moreover, genotypes covered by nonavalent vaccine contributed to 85.2% of CIN2 lesions, 97.9% of CIN3 and 93.8% of cancers.ConclusionsPartial extended genotyping such as HPV33/31/58 but not multiplicity of HPV infections could serve as a promising triage for HPV-positive self-samples. Moreover, incidence rates of cervical cancer and precancer were substantial attributable to HPV genotypes covered by current nonavalent vaccination.

Trends in Incidence Rates, Mortality Rates, and Age-Period-Cohort Effects of Cervical Cancer - China, 2003-2017.

This study reported the trends and analyzed the age-period-cohort effects on the incidence and mortality rates of cervical cancer in China. The age-standardized incidence rate (ASIR) and mortality rate (ASMR) by Segi's world standard population were calculated using qualified consecutive data from 22 cancer registries from 2003 to 2017 in China. We performed joinpoint analysis to describe the trends and age-period-cohort analysis to estimate the independent effects of age, period and cohort on trends in incidence and mortality rates of cervical cancer. The ASIR and ASMR for cervical cancer in females over 20 years old increased during 2003-2017. For females <50 years, a decreasing trend in ASIR and a stable trend in ASMR were observed in urban areas after 2009. But the ASIR and ASMR kept increasing in rural areas during the whole period. For females >50 years, the ASIR and ASMR increased both in urban and rural areas. Age-period-cohort analysis showed increasing period effects on cervical cancer incidence and mortality during the whole period. The cohort effects exhibited a downward-upward-downward pattern for the incidence (1918-1938, 1938-1963, 1963-1993) and mortality rates (1918-1943, 1943-1963, 1963-1993) in urban areas, a fluctuating pattern for incidence rate and a continuing downward pattern for mortality rate (1918-1993) in rural areas. The increases in cervical cancer incidence and mortality rates can be mostly explained by period effects. We observed decreases in risk for cervical cancer incidence and mortality in young female generations, which were more obvious in urban areas.

Cervical Cancer Awareness and Screening Practises Amongst Migrant Women Living in Sydney

Cervical cancer is the 4^th most prevalent cancer among women worldwide. The incidence rate of cervical cancer is low in Australia. Despite the use of vaccinations and cervical screening programs in Australia, migrant women living in Sydney still face significant health disparities when accessing cervical cancer screening services. Overall, there are limited studies that explore the barriers and facilitators that migrant women are exposed to when accessing cervical screening tests. The aim of this study is to describe the attitudes, beliefs, knowledge and awareness of cervical cancer screening and screening practices amongst migrant women aged 25 and above living in Sydney, Australia for more than one year with no history of cervical cancer. Fifty-two women (30 South-East Asian, 12 Middle Eastern & 10 African) were recruited using two non-probabilistic sampling methods, convenience and snowball sampling. Data was collected through Focus Group Discussions (FGDs). In total, 5 FGDs were conducted in homogenous groups of 8-12 participants. Each FGD was audio-recorded and verbatim transcribed. The data were analysed using thematic analysis. Results show that average age of the participants were 38 years, majority were from South East Asia (58%), married (87%), unemployed (65%), had tertiary education (67%), were in low income categories (84%), and a third (35%) living in Australia for < 5 years. Results further show that migrant women living in Sydney displayed a lack of awareness and knowledge about cervical cancer and screening practices. Individual and system-level barriers and facilitators that influenced screening attendance were identified. Factors such as lack of knowledge, emotional barriers, cultural and religious barriers, psychological barriers, and organisational factors influence screening practices. Furthermore, results also revealed that African migrants were less likely to be aware of cervical cancer and screening compared to South-East Asian and Middle Eastern women. Our study also reported that short-term migrants had an overall lack of awareness about cervical screening and therefore, differences in migration status must be considered when administering health education programs. Understanding migrant women’s experiences, facilitators, and barriers to accessing cervical screening is essential in assisting health care professionals and policy makers to provide culturally appropriate services. Provision of training or programs to increase culturally appropriate health services amongst health care providers is also recommended. To increase cervical cancer screening uptake of migrant women living in Sydney, culturally appropriate education programs and health promotion strategies targeted towards different ethnic groups need to be administered.

Prikaz HPV testiranja kao primarnog skrininga raka grlića materice

Cytology-based cervical cancer screening achieved undisputable success in reducing the incidence and mortality of cervical cancer in many countries of the world, especially high-income countries. However, in lowand middle-income countries substantial reductions in cervical cancer incidence rates have not been achieved, mainly due to the difficulties in realization of complex conditions for implementing high quality cytology-based cervical cancer screening programs. Most international guidelines, including the World Health Organisation (WHO) Global Strategy, now recommend high-risk human papillomavirus (hrHPV) testing as the preferred cervical screening test, for several reasons, primarily due to its sensitivity, less subjectivity in diagnosis and possibility of easier program organization and implementation. The advantages of primary hrHPV screening include higher sensitivity of technology compared to cytology based examinations, and increased specificity in populations where large proportions of women have been vaccinated against the human papillomavirus (HPV), while the high-negative predictive value enables prolongation of screening intervals to 7 to 10 years, which increases the cost effectiveness of the screening programme, when applied at population level. Also, primary hrHPV screening for cervical cancer can be carried out by self-taken samples which increases the feasibility of such cervical cancer screening programme. However, implementing primary hrHPV cervical cancer screening requires at the same time organised system of monitoring the implementation of the program, coordination and quality assurance of all processes within the implementation of cervical cancer screening.Effective hrHPV primary cervical cancer screening programme requires the triage of hrHPV positive women to maximise the detection of clinically relevant cervical lesions for further investigation. Most of the countries that introduced hrHPV primary cervical cancer screening use visual inspection with acetic acid (VIA), cytology based examination or HPV geno-typing with cytology for triage testing. The choice of triage strategy depends on various factors, including availability of resources, effectiveness and cost of procedures to recall women for triage testing as well as the capacity and quality of existing health services to deliver the triage tests. Implementation of self-sampling also requires a number of issues to be addressed, including communication to motivate participation and to inform women about the self-sampling procedure, delivery of the self-sampling kits and return of the samples to the laboratories, laboratory procedures, communication of results, recalling screen-positive women for further examination and triage and motivating them to attend for follow-up and treatment. Finally, the introduction primary screening for HPV on the mucous membrane of the cervix should be accompanied by awareness-raising programs to improve the information and knowledge of women and the entire population about the importance of the cervical cancer screening, which would improve the results of population based cervical cancer screening programs and increase the women's participation.

The Prevalence of Cervical HPV Infection and Genotype Distribution in 856,535 Chinese Women with Normal and Abnormal Cervical Lesions: A Systemic Review.

Cervical cancer is the commonest cancer affecting women worldwide. During the last decades, the incidence and mortality rates of cervical cancer have increased in China. This research aims to assess the overall and genotype-specific prevalence of the human papillomavirus (HPV) infection among Chinese women with normal cervix, considering age, and geographic location. We selected studies about HPV prevalence in women from Chinese in Mainland China with normal cervix and abnormal cervical lesions, published between January 1995 and December 2020. The HPV prevalence was analyzed using meta-analysis based on the following: cytological and histological diagnoses, regions, and ages. The overall HPV prevalence in 856,535 women was 14.3%, 95% confidence interval (CI) and it increased from 8.2% to 16.5% in studies published from 2006 to 2020. The prevalence of high-risk (HR) and low-risk (LR) HPV types was 11.3% and 2.7%, respectively. The commonest types of HPV in women from Mainland China were HPV 16 (2.6%), 52 (2.4%), 58 (1.7%), 18 (0.9%), and 33 (0.8%). According to the geographical analysis, the prevalence of different HPV genotypes varied by region, Central China had the highest overall HPV prevalence. HPV16 was the commonest type in all the regions except in South China and East China, where HPV52 was found to be common. Regarding diagnosis, the HPV infection led to cervical cancer diagnosis by cytology and histology with 90.1% and 91.5% rates, respectively. HPV16 and HPV18 were common types associated with cervical cancer diagnosed by cytology and histology. HPV 16, 58, 52, 18, and 33 were the commonest types found in women with normal cervixes from Mainland China. The prevalence of different HPV genotypes varied by age group and region.

The Incidence of Malignant Tumors of the Female Reproductive System in St. Petersburg

Introduction: Malignant neoplasms remain a serious sociomedical problem that requires solutions to health care optimization. In the overall structure of cancer incidence in the female population in 2018, uterine and cervical cancer ranked third (8.0 %) and fifth (5.2 %), respectively. Objective: To determine the main trends in the incidence of gynecologic cancers in Saint Petersburg, Russian Federation, and to monitor achievement of the targets of the Fight against Cancer Program. Materials and methods: To assess the prevalence and the structure of the incidence of malignant neoplasms of the female reproductive system, a comprehensive methodology was developed, which included the analysis of statistical reporting forms officially approved by the Ministry of Health of the Russian Federation for 2010–2020. Results: The prevalence of gynecologic cancers showed a steady rise. In 2011–2019, the incidence rates of cervical, uterine and ovarian cancer in St. Petersburg increased by 6.9 %, 18.2 %, and 18.5 %, respectively. The proportion of cases of the uterine body cancer was the largest (43.6 %), followed by ovarian (28.7 %) and cervical cancer (22.5 %). The shares of malignant neoplasms of other sites, including vulva, vagina and placenta, were much lower and equaled 3.9 %, 1.2 %, and 0.1 %, respectively. At the same time, the percentage of followed-up patients with stages I and II uterine cancer had grown from 74.4 % in 2011 to 79.4 % in 2020 (t = 4.9, p &lt; 0.05) and of those with stages I and II ovarian cancer – from 32.2 % to 35.5 % (t = 3.7, p &lt; 0.05). The one-year gynecologic cancer mortality rate in St. Petersburg decreased significantly, from 25.8 % to 20.1 % (t = 4.0, p &lt; 0.05), while the five-year survival in 2011–2020, on the contrary, increased from 52.3 % to 57.9 %. Conclusions: Malignant tumors of the female reproductive system rank first in the structure of the annual cancer incidence. Every sixth (15.1 %) incident cancer is a gynecologic neoplasm. In 2011–2019, rising incidence rates were observed for the most common female genital tract tumors, including cervical, uterine, and ovarian cancer. It is of great concern that not all monitored indicators approved by the Fight against Cancer Program are being properly implemented in St. Petersburg.

Incidence and Mortality by the Main Types of Cancer in the City of Cuiabá, Mato Grosso, Between the Years of 2008 and 2016.

To analyze the temporal trend of the incidence and mortality rate for prostate, breast, colorectal, lung, cervical, stomach and laryngeal cancer among residents in the city of Cuiabá between 2008 and 2016. Time series study with data from the Mortality Information System and the Population-Based Cancer Registry. Stratified by sex, the proportional distribution of new cases and deaths by age group and the cancer incidence and mortality rates standardized by the world population were calculated. Linear regression was used and the annual percentage change (APC) was estimated. In males, most new cases and deaths, for the main types of cancer, occurred among those aged 50 years or older, and the incidence rate of prostate cancer showed a tendency to decrease in the period (APC=-4.33%). For females, the proportion of new cases and deaths, due to breast and cervical cancer, were more frequent among women aged 50 years or younger, and lung, stomach and colorectal cancer among women aged 50 years or older. The incidence rate of breast cancer showed an increasing trend (APC=3.60%). For both sexes, the mortality rate remained stable. The incidence rate trend varied between sexes, an increase was observed for breast cancer among women and a reduction for prostate cancer among men. The mortality rate for the main types of cancer was stable.

Cervical Cancer in the Baltic States: Can Intelligent and Personalized Cancer Screening Change the Situation?

.The three Baltic States (Estonia, Latvia, and Lithuania) are among the European Union countries with the highest incidence and mortality rates for cervical cancer. In order to tackle this public health challenge, there is an urgent need to implement more advanced and effective methods in cervical cancer prevention in Baltic countries.Nationwide cervical cancer screening programs in the Baltic States commenced in 2004–2009. While the organized screening programs in these countries differ in some relevant details (target age groups, screening interval), the underlying principles and problems, barriers are universal. However, the outcomes of present screening programs are unsatisfactory. In addition, universal screening programs are extremely costly. There is a potential need for more intelligent and personalized cervical cancer screening program. In 2019 the project “Towards elimination of cervical cancer: intelligent and personalized solutions for cancer screening” (2020–2023) was developed with the main objective – to develop improved and personalized cancer screening methods within a sustainable health care system.It is expected, that more sophisticated cervical cancer screening model will be implemented in Estonia, Latvia, and Lithuania, and will have a positive impact to epidemiology of cervical cancer and public health in general.

Organizovani skrining raka grlića materice u Domu zdravlja "Novi Sad"

Cervical cancer can be prevented and cured by early detection. Yet, it is the fourth most common type of cancer among women worldwide. According to data from the Cancer Registry of the Institute of Public Health of Serbia "Dr. Milan Jovanović Batut," 1044 newly diagnosed cases were registered among women and 438 women died from this malignant localization in 2019. Human papillomavirus infection (hereinafter referred to as: HPV) is the most important risk factor for the development of cervical cancer. Thanks to the natural course of HPV infection and the biological behaviour of premalignant changes in the cervix, cervical cancer prevention can be carried out at the primary, secondary and tertiary prevention levels. Secondary prevention involves screening (early detection of asymptomatic forms of the disease) and represents an organized mass invitation of the target population of women (aged between 25 and 64 years) for testing and interpretation of test results, followed by quality assurance control and reporting. Organized screening is done at threeyear intervals in the healthy population and allows for detecting not only malignant disease but also precancerous changes whose removal prevents the occurrence of malignant diseases. The methodology used in this paper included the monitoring of screening results performed at the "Novi Sad" Health Centre in the period from 2013 to 2022. The documentation of the institution's regular reporting on screening results, which contains depersonalized aggregated data, was used as a data source. In the statistical data analysis, descriptive statistics was used and the data have been presented in tabular form. The Women's Health Care Service with its Cytology laboratory has been the implementer of the organized cervical cancer screening program at the "Novi Sad" Health Centre since 2013 (covering a population of 110,067 women aged 25 to 64 for the territory of the municipality of Novi Sad and the municipality of Sremski Karlovci). The gynaecology service of the "Novi Sad" Health Centre was highly commended by the Cervical Cancer Screening Office for the results achieved in terms of the highest coverage of the target population and the largest number of Pap smear tests performed. In the period from March 2013 to July 2022, a total of 210,410 swabs, of which 9,469 (4.5%) showed atypia, were taken for screening purposes at the "Novi Sad" Health Centre. The aim of the paper was to show the organization of the "Novi Sad" Health Centre as well as the results achieved in organized cervical cancer screening, as a secondary prevention measure that can contribute to the reduction in cervical cancer incidence and mortality rates among women.

Modelos para previsão das taxas de incidência e mortalidade do câncer do colo do útero

Objective: analyze and predict cervical cancer incidence and mortality rates, using time series models. Method: ecological study, carried out in the capital Matogrossense. The incidence data were from the Population Based Cancer Registry, from 2000 to 2012, and mortality data, from 1981 to 2018, obtained from the Mortality Information System. And analyzed by the ARIMA and HOLT models. Results: the series of the incidence rate of carcinoma in situ, the appropriate model was the AR (1). Estimated projections (2013-2014) fluctuated between 15,54 and 16,45 per hundred a thousand women. In the invasive cervixl series, the model was Holt’s, and the predictions (2013-2014), with values between 11,28 to 8,9 per 100 thousand women. In the mortality rate, the satisfactory model was ARMA (1,1), whose predictions (2019-2020) fluctuated between 9,46 and 9,62 per 100 thousand women. Conclusion: in the three cases, the predicted rates presented levels close to those observed, indicating that the models allowed estimating and predicting, in an adequate way. It was also possible to observe a slight increase in in situ cancer and a decline in the incidence of invasive cancer, while mortality showed stability in the results and predictions. Descriptors: ARIMA; Cervical Cancer; Incidence; Mortality; Holt's method.

Abstract PO-005: Geospatial hotspot analysis of cervical cancer among Asian American Native Hawaiian Pacific Islander (AANHPI) population in Los Angeles County

Abstract Background: Higher cervical cancer incidence rates among subgroups of Asian American Native Hawaiian Pacific Islander (AANHPI) women are often overlooked in studies that aggregate this extremely heterogeneous population. There is a need to geographically target ethnic subgroup communities with the highest needs with culturally responsive services for cancer prevention. We analyzed the distribution of cervical cancer clusters among the ethnic subgroups of AANHPI women in Los Angeles County. Methods: We included data for first primary cancer cases with any stage of cervical cancer (only malignant tumors) diagnosed from 2000 to 2018 among AANHPI from the Los Angeles County Cancer Surveillance Program. We performed hotspot analyses using the Getis-Ord GI*statistic in ArcGIS to compare the distribution of statistically significant clusters of cervical cancer cases in Los Angeles County using a fixed band. Hot and cold spots with less than 11 cases were suppressed to protect patient confidentiality. Results: Among 8,708 cases of cervical cancer, AANHPI population accounted for 1332 cases (15%). Among the AANHPI population, the three most prevalent ethnic groups were Filipino (n=364, 28%), Chinese (n=314, 24%), and Korean (n=232, 18%) Americans. The hotspots varied by ethnic subgroups and emerged in areas with high proportions of Filipino (Glendale/Carson), Chinese (Arcadia/El Monte), and Korean (Hollywood Hills) American residents, respectively. Discussion: Our findings geospatially disaggregate the cervical cancer prevalence among AANHPI population in Los Angeles County by ethnic subgroups. Specifically, the cervical cancer hotspots contextualize potential geographic- and area-level factors that affect access to preventive services for these vulnerable populations and can facilitate allocating resources for culturally responsive services to increase uptake of HPV vaccination and screening. Citation Format: Michelle B. Shin, Bibiana Martinez, Jennifer Tsui. Geospatial hotspot analysis of cervical cancer among Asian American Native Hawaiian Pacific Islander (AANHPI) population in Los Angeles County [abstract]. In: Proceedings of the AACR Virtual Conference: 14th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2021 Oct 6-8. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PO-005.

Human Papillomavirus Vaccination and Trends in Cervical Cancer Incidence and Mortality in the US

This cohort study examines the association of human papillomvirus vaccination with cervical cancer incidence and mortality rates in the US, comparing age groups understood to have differing levels of vaccination.

Association Between Neighborhood Socioeconomic Inequality and Cervical Cancer Incidence Rates in New York City

This cross-sectional study uses Agency for Healthcare Research and Quality data to compare incidence of cervical cancer in the lowest–socioeconomic status neighborhoods with that in higher–socioeconomic status neighborhoods of New York City from 2012 through 2016.