School of Population Health, UNSW Sydney, Sydney 2052, Australia.
School of Population Health, UNSW Sydney, Sydney 2052, Australia.
Gynecol Oncol. 2021 Dec;163(3):583-592. doi: 10.1016/j.ygyno.2021.10.075. Epub 2021 Oct 20.
This study investigated the global incidence and mortality of cervical cancer, its predictors, the temporal trend by country and age.
Data from Global Cancer Observatory 2020 for 185 countries was used to estimate current cervical cancer incidence and mortality and their associations with predictors by linear regression analysis. Estimated age-standardized rates (ASR) and average annual percentage changes (AAPC) from cancer registries for up to 53 countries through 2018 were used for trend analysis by joinpoint regression.
Wide variations in cervical cancer were observed globally with the highest rates of incidence and mortality in East Africa (ASR, 40.1 and 28.6). The incidence and mortality of cervical cancer were positively associated with human papillomavirus, human immunodeficiency virus infection and negatively associated with cervical cancer screening coverage. In the most recent 5 years, reduction of incidence and mortality was found from 22 (AAPC, -11.2 to -0.5) and 27 countries (-21.5 to -0.3). Increase of incidence and mortality was found from 13 (1.7 to 6.5) and 5 (0.3 to 1.8) countries. Comparing to women aged above 50 years, increasing incidence were additionally found among women under age 50 years from 9 countries (ranging from 0.2 in Denmark to 3.8 in Sweden).
While most countries with cancer registry have shown reduction in cervical cancer incidence and mortality, the increasing incidence among younger women from some developed countries warrants further implementation of effective cancer screening.
本研究调查了宫颈癌的全球发病率和死亡率、其预测因素、按国家和年龄划分的时间趋势。
使用 2020 年全球癌症观测站 185 个国家的数据,通过线性回归分析估计当前宫颈癌的发病率和死亡率及其与预测因素的关联。使用截至 2018 年多达 53 个国家的癌症登记处的估计年龄标准化率(ASR)和平均年百分比变化(AAPC)进行趋势分析,采用联合点回归。
全球范围内宫颈癌的发病率差异很大,东非的发病率和死亡率最高(ASR,40.1 和 28.6)。宫颈癌的发病率和死亡率与人类乳头瘤病毒、人类免疫缺陷病毒感染呈正相关,与宫颈癌筛查覆盖率呈负相关。在最近的 5 年中,22 个国家(AAPC,-11.2 至-0.5)和 27 个国家(-21.5 至-0.3)的发病率和死亡率有所下降。13 个国家(1.7 至 6.5)和 5 个国家(0.3 至 1.8)的发病率和死亡率有所上升。与 50 岁以上的女性相比,9 个国家(丹麦为 0.2,瑞典为 3.8)的 50 岁以下女性的发病率也在增加。
虽然大多数有癌症登记处的国家的宫颈癌发病率和死亡率都有所下降,但一些发达国家的年轻女性发病率上升,这需要进一步实施有效的癌症筛查。