Temporal trends of cervical cancer between 1990 and 2019, in Asian countries by geographical region and socio-demographic index, and comparison with global data
Authors: Momenimovahed Zohre , Mazidimoradi Afrooz , Amiri Sanaz , Nooraie Zeinab , Allahgholi Leila , Salehiniya Hamid 
Published: June 2023

Abstract

Objectives
Cervical cancer is the fourth most common cancer in women and one of the most important health challenges in the world. Although the epidemiological statistics of cervical cancer seem to be varied in Asia, no study has evaluated the trend of this disease and the changes in its incidence and epidemiology in recent decades. Therefore, this study was conducted to determine the temporal trend of cervical cancer between 1990 and 2019 in Asian countries based on geographic region and socio-demographic index (SDI), and also compare it with global data.

Methods
We collected cervical cancer data from the 2019 Global Burden of Disease (GBD) study from 1990 to 2019 in 49 Asian countries and territories. In this study, data were extracted in different classifications of Asian countries based on an SDI, and five GBD categories for Asian countries from 1990 to 2019 and compared with global data. Data were reported in values with a confidence interval (CI) of 95%. We used relative difference (%) between years to show the comparative changes in incidences, prevalence, deaths, and disability-adjusted life years (DALY) age-standardized rates. Average annual percentage change (AAPC) and its 95% CI in the 30-year past period for each location were calculated by using age-standardized rates (ASR) and with Joinpoint version 4.9.1.0 software.

Results
In Asia, the number of cervical cancer incidences, prevalence, death, and DALYs increased to 1.94, 2.26, 1.7, and 1.5-fold, respectively; while globally, these numbers increased by 1.67, 1.89, 1.52, and 1.45 times, respectively. In Asia, the AAPC of cervical cancer age-standardized incidence rate (ASIR), age-standardized prevalence rate (ASPR), the age-standardized death rate (ASDR), and DALYs age-standardized rates (DALYs ASRs) were −0.3, 0.5, −1.0, and −1.0 respectively. The AAPC of these indicators worldwide was −0.4, 0.2, −0.9, and −0.9, respectively. South Asia and Southeast Asia experienced the highest decrease in ASIR of cervical cancer from 1990 to 2019. In 2019, all GBD regions of Asia experienced a decreasing trend in ASDR and DALYs ASRs of cervical cancer. In 2019, the highest ASIR, ASPR, ASDR, and DALYs ASR of cervical cancer belonged to Brunei Darussalam, Brunei Darussalam, Mongolia, and Mongolia, respectively, and the lowest in all above categories was related to the Syrian Arab Republic, Syrian Arab Republic, Kuwait, and Kuwait; respectively.

Conclusions
Although the epidemiological statistics of cervical cancer in Asia have started to decline, this disease is still one of the most important causes of death for women in this region. So it seems in addition to improving screening coverage and management, we need to implementation of educational and awareness-raising interventions regarding cervical cancer, eliminate misconceptions related to testing results, and emphasize the preventable nature of this cancer by early detection using screening methods.