Shimels Tariku, Kantelhardt Eva Johanna, Assefa Mathewos, Fenta Teferi Gedif
Pharmacology, St Paul's Hospital Millennium Medical College, Addis Ababa, Gulele, Ethiopia
Pharmaceutics and Social Pharmacy, Addis Ababa University College of Health Sciences, Addis Ababa, Ethiopia.
BMJ Open. 2025 Jan 20;15(1):e089521. doi: 10.1136/bmjopen-2024-089521.
This study analysed the spatial and temporal patterns of cervical cancer incidence in Addis Ababa from 2012 to 2021.
An ecological study was conducted from 1 September to 30 November 2023 to examine the spatiotemporal trends of cervical cancer incidence.
The research was conducted in Addis Ababa, the capital city of Ethiopia.
Included were all patients with clinically and/or histopathologically confirmed diagnoses of cervical cancer.
The study employed advanced analytical tools including R programming, Quantum Geographic Information System V.3.36.0, GeoDa V.1.2.2 and System for Automated Geoscientific Analyses GIS V.9.3.2. Techniques such as Bayesian empirical testing with a block weighting matrix for hotspot identification, Global Moran's I for spatial autocorrelation, nearest neighbour imputation and universal Kriging interpolation were used to manage data gaps. Joinpoint trend analysis and direct age-standardised incidence rate (ASIR) using the Segi's World standard population was applied to compare trends across subcities. A statistical significance threshold was set at p<0.05.
Between 2012 and 2021, a total of 2435 new cervical cancer cases were recorded in the Addis Ababa City Population-based Cancer Registry, with significant spatial clustering observed in Nifas Silk Lafto, Bole, Kirkos as well as parts of Gulele and Yeka sub cities (z score>1.96) in 2018. The citywide age-standardised incidence rate varied from 19 to 26 cases per 100 000 women-years during 2013 and 2016, respectively. Subcity trends varied significantly, with increases and decreases noted in Akaki Kality and Kolfe Keraniyo over different periods while Bole subcity showed modest increase at 4.2% APC (95% CI: 0.6% to 7.9%; p=0.026).
The study highlights substantial fluctuations in ASIR and significant geographic disparities in cervical cancer throughout Addis Ababa. To address these challenges, the implementation of school-based human papillomavirus vaccination programmes, alongside targeted interventions, active campaigns and sustained surveillance, is critical. These strategies are essential to effectively reduce the cervical cancer burden and improve health outcomes in the community.
本研究分析了2012年至2021年亚的斯亚贝巴宫颈癌发病率的时空模式。
于2023年9月1日至11月30日进行了一项生态研究，以考察宫颈癌发病率的时空趋势。
研究在埃塞俄比亚首都亚的斯亚贝巴开展。
纳入所有临床和/或组织病理学确诊为宫颈癌的患者。
该研究采用了先进的分析工具，包括R编程、量子地理信息系统V.3.36.0、GeoDa V.1.2.2和自动地球科学分析地理信息系统V.9.3.2。采用贝叶斯经验检验（使用块加权矩阵进行热点识别）、全局莫兰指数（用于空间自相关）、最近邻插补和通用克里金插值等技术来处理数据缺口。采用连接点趋势分析和使用世标人口的直接年龄标准化发病率（ASIR）来比较各子城市的趋势。设定统计显著性阈值为p<0.05。
2012年至2021年期间，亚的斯亚贝巴市基于人群的癌症登记处共记录了2435例新的宫颈癌病例，2018年在尼法斯丝绸拉夫托、博莱、基尔科斯以及古莱勒和耶卡部分子城市观察到显著的空间聚集（z分数>1.96）。2013年和2016年期间，全市年龄标准化发病率分别为每10万女性年19例至26例。各子城市的趋势差异显著，阿卡基卡利蒂和科尔费凯拉尼奥在不同时期有升有降，而博莱子城市呈适度上升，年平均百分比变化（APC）为4.2%（95%CI：0.6%至7.9%；p=0.026）。
该研究突出了亚的斯亚贝巴宫颈癌年龄标准化发病率的大幅波动以及显著的地理差异。为应对这些挑战，实施基于学校的人乳头瘤病毒疫苗接种计划，同时辅以有针对性的干预措施、积极的宣传活动和持续的监测至关重要。这些策略对于有效减轻宫颈癌负担和改善社区健康结果至关重要。
