[Spatial and spatiotemporal inequalities in premature mortality due to cervical cancer in Argentina (2001-2020)Desigualdades espaciais e espaço-temporais na mortalidade prematura por câncer do colo do útero na Argentina (2001-2020)].

OBJECTIVE

To estimate years of life lost (YLL) due to cervical cancer (CC) at the subnational level in Argentina from 2001 to 2020 and identify spatial and spatiotemporal clusters of CC mortality.

METHODS

Ecological time-series study. Mortality data were obtained from the Directorate of Health Statistics and Information, and population data, from the censuses conducted by the National Statistics and Census Institute and intercensal projections. Crude and age-adjusted YLL rates, grouped into five-year periods, were estimated for each province of Argentina. Spatial autocorrelation techniques were applied, namely Moran's index, local indicators of spatial association and space-time scan statistics, to detect spatiotemporal clustering.

RESULTS

In the period 2001-2020, 37 265 deaths due to cervical cancer were recorded, corresponding to 1 398 661 YLL. The adjusted YLL rate showed a significant increase between the first five-year period (5.42 per 1000; 95%CI, 5.40-5.44) and the last (5.75 per 1000; 95%CI, 5.73-5.76). All provinces exhibited stable or rising rates, except for Jujuy and Santa Cruz, both of which had significant reductions in YLL. Persistence of a spatial cluster over time was observed in the North of the country, and spatiotemporal clustering of high rates was detected in the Northwest region (Salta/Jujuy) during the years 2001-2009 and in the Northeast region in 2011-2020.

CONCLUSIONS

Premature mortality due to cervical cancer in Argentina showed a rising trend over the study period, with a greater concentration in northern provinces. The decline observed in some provinces could be attributed partly to differences in the implementation of prevention programs.