Trends in cervical cancer mortality rates in Lithuania, 1987-2016.

BACKGROUND

The aim of this study was to investigate time trends in cervical cancer mortality rates in Lithuania across age groups and time periods over a 30-year time span.

METHODS

Data on numbers of deaths from cervical cancer during the period 1987-2016 were obtained from the WHO mortality database. Trends in age-standardised mortality rates (ASR, world standard), and age-specific rates were analysed by calculating annual percentage change (APC) using Joinpoint regression. In addition, age-period-cohort analysis was performed.

RESULTS

Joinpoint regression analysis indicated that mortality from cervical cancer increased by 2.0% (95% CI: 1.2, 2.9) annually from 1987 to 2002 and decreased by 2.3% (95% CI: 3.2, 1.3) annually thereafter. In age groups 20-39 and 40-49 years after a sharp increase by 5.6% (95% CI: 2.6, 8.7) and 5.9% (95% CI: 2.7, 9.2), respectively, mortality rates declined since around 2000 with slopes of -4.8% (95% CI: -7.6, -1.9) and -2.7% (95% CI: -4.7, -0.6), respectively. Among women aged 50-59 years there was an increase in mortality (APC = 2.6%; 95% CI: 0.8, 4.5) followed by decrease with a not statistically significant slope (APC = -2.2%; 95% CI: -5.1, 0.7) since 2004. For older women mortality rates moderately declined during the entire time span. The age-period-cohort analysis suggests that temporal trends in cervical cancer mortality rates could be attributed to period and cohort effects.

CONCLUSIONS

Opportunistic screening may have contributed to favourable recent changes in cervical cancer mortality rates in Lithuania, however not to the extent seen in most European countries.