Trends in cervical cancer incidence in sub-Saharan Africa

Abstract

Background: Cervical cancer is the second most common cancer and the leading cause of cancer death in women in sub-Saharan Africa (SSA).

Methods: Trends in the incidence of cervical cancer are examined for a period of 10-25 years in 10 population-based cancer registries across eight SSA countries (Gambia, Kenya, Malawi, Mauritius, Seychelles, South Africa, Uganda and Zimbabwe). A total of 21,990 cases of cervical cancer were included in the analyses.

Results: Incidence rates had increased in all registries for some or all of the periods studied, except for Mauritius with a constant annual 2.5% decline. Eastern Cape and Blantyre (Malawi) registries showed significant increases over time, with the most rapid being in Blantyre (7.9% annually). In Kampala (Uganda), a significant increase was noted (2.2%) until 2006, followed by a non-significant decline. In Eldoret, a decrease (1998-2002) was followed by a significant increase (9.5%) from 2002 to 2016.

Conclusion: Overall, cervical cancer incidence has been increasing in SSA. The current high-level advocacy to reduce the burden of cervical cancer in SSA needs to be translated into support for prevention (vaccination against human papillomavirus and population-wide screening), with careful monitoring of results through population-based registries.

Fig. 1

Cervical cancer age standardized incidence rates by year of diagnosis, with best fitting regression line, and corresponding coefficients of determination (R2).

Fig. 2

Cervical cancer age standardised incidence rate (ASR) (with 95% confidence intervals) in Seychelles and Bulawayo, by period of diagnosis.

Fig. 3

Age-specific incidence rates from recent time periods, 10 registries.

Fig. 4

Age-specific incidence rate (ASR) of cervical cancer in Harare and Kampala by period of diagnosis (a) and by birth cohort (b).