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. 2022 Dec 2;4(48):1070-1076.
doi: 10.46234/ccdcw2022.216.

Trends in Incidence Rates, Mortality Rates, and Age-Period-Cohort Effects of Cervical Cancer - China, 2003-2017

Kexin Sun  1 , Rongshou Zheng  1 , Lin Lei  2 , Siwei Zhang  1 , Hongmei Zeng  1 , Shaoming Wang  1 , Li Li  1 , Ru Chen  1 , Bingfeng Han  1   2   3 , Ji Peng  2 , Wenqiang Wei  1 , Jie He  3
Affiliations

Trends in Incidence Rates, Mortality Rates, and Age-Period-Cohort Effects of Cervical Cancer - China, 2003-2017

Kexin Sun et al. China CDC Wkly. .

Abstract

Introduction: This study reported the trends and analyzed the age-period-cohort effects on the incidence and mortality rates of cervical cancer in China.

Methods: The age-standardized incidence rate (ASIR) and mortality rate (ASMR) by Segi's world standard population were calculated using qualified consecutive data from 22 cancer registries from 2003 to 2017 in China. We performed joinpoint analysis to describe the trends and age-period-cohort analysis to estimate the independent effects of age, period and cohort on trends in incidence and mortality rates of cervical cancer.

Results: The ASIR and ASMR for cervical cancer in females over 20 years old increased during 2003-2017. For females <50 years, a decreasing trend in ASIR and a stable trend in ASMR were observed in urban areas after 2009. But the ASIR and ASMR kept increasing in rural areas during the whole period. For females >50 years, the ASIR and ASMR increased both in urban and rural areas. Age-period-cohort analysis showed increasing period effects on cervical cancer incidence and mortality during the whole period. The cohort effects exhibited a downward-upward-downward pattern for the incidence (1918-1938, 1938-1963, 1963-1993) and mortality rates (1918-1943, 1943-1963, 1963-1993) in urban areas, a fluctuating pattern for incidence rate and a continuing downward pattern for mortality rate (1918-1993) in rural areas.

Conclusions: The increases in cervical cancer incidence and mortality rates can be mostly explained by period effects. We observed decreases in risk for cervical cancer incidence and mortality in young female generations, which were more obvious in urban areas.

Keywords: age-period-cohort incidence; cervical cancer; mortality.

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Conflict of interest statement

No conflicts of interest.

Figures

Figure 1
Figure 1
The trends of incidence and mortality rates of cervical cancer by age group and area, from 2003 to 2017. (A) Incidence rates in all areas, (B) Incidence rates in urban areas, (C) Incidence rates in rural areas, (D) Mortality rates in all areas, (E) Mortality rates in urban areas, (F) Mortality rates in rural areas.
Figure 2
Figure 2
The age-specific incidence and mortality rates of cervical cancer, by time period and area. (A) Incident rates in all areas. (B) Incident rates in urban areas. (C) Incident rates in rural areas. (D) Mortality rates in all areas. (E) Mortality rates in urban areas. (F) Mortality rates in rural areas.
Figure 3
Figure 3
The birth cohort-specific incidence and mortality rates of cervical cancer, by area. (A) Incident rates in urban areas. (B) Incident rates in rural areas. (C) Mortality rates in urban areas. (D) Mortality rates in rural areas.
Figure 4
Figure 4
The result of age-period-cohort analysis of incidence and mortality rates of cervical cancer, by area. (A) Incident rates in urban areas; (B) Incident rates in rural areas; (C) Mortality rates in urban areas; (D) Mortality rates in rural areas.
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