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. 2023 May 25:12:e81752.
doi: 10.7554/eLife.81752.

Approximating missing epidemiological data for cervical cancer through Footprinting: A case study in India

Irene Man  1 , Damien Georges  1 , Maxime Bonjour  1 , Iacopo Baussano  1
Affiliations

Approximating missing epidemiological data for cervical cancer through Footprinting: A case study in India

Irene Man et al. Elife. .

Abstract

Local cervical cancer epidemiological data essential to project the context-specific impact of cervical cancer preventive measures are often missing. We developed a framework, hereafter named Footprinting, to approximate missing data on sexual behaviour, human papillomavirus (HPV) prevalence, or cervical cancer incidence, and applied it to an Indian case study. With our framework, we (1) identified clusters of Indian states with similar cervical cancer incidence patterns, (2) classified states without incidence data to the identified clusters based on similarity in sexual behaviour, (3) approximated missing cervical cancer incidence and HPV prevalence data based on available data within each cluster. Two main patterns of cervical cancer incidence, characterized by high and low incidence, were identified. Based on the patterns in the sexual behaviour data, all Indian states with missing data on cervical cancer incidence were classified to the low-incidence cluster. Finally, missing data on cervical cancer incidence and HPV prevalence were approximated based on the mean of the available data within each cluster. With the Footprinting framework, we approximated missing cervical cancer epidemiological data and made context-specific impact projections for cervical cancer preventive measures, to assist public health decisions on cervical cancer prevention in India and other countries.

Keywords: HPV prevalence; cervical cancer incidence; classification; clustering; epidemiology; global health; impact projection; sexual behaviour; viruses.

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Conflict of interest statement

IM, DG, MB, IB No competing interests declared

Figures

Figure 1.
Figure 1.. Hierarchical structure of availability of cervical cancer epidemiological data.
Figure 2.
Figure 2.. Identified clusters of registry-specific cervical cancer incidence.
Clusterings under (A) 2, (B) 3, and (C) 4 prefixed clusters. Each panel within a row corresponds to a cluster within a k-clustering, with the cluster label given on top of the panel. The cervical cancer incidence data were extracted from volume XI of Cancer Incidence in Five Continents (CI5) (Bray et al., 2017) and the 2012–2016 report by the Indian National Centre for Disease Informatics and Research (NCDIR) (Report of National Cancer Registry Programme, 2020). Black: cluster mean of cervical cancer incidence; dark grey: registry incidence assigned to the cluster; light grey: registry incidence assigned to other clusters.
Figure 2—figure supplement 1.
Figure 2—figure supplement 1.. Registry-specific cervical cancer incidence data from Cancer Incidence in Five Continents (CI5) and National Centre for Disease Informatics and Research (NCDIR).
See Figure 1—source data 1 for whether registries belong to CI5 or NCDIR.
Figure 2—figure supplement 2.
Figure 2—figure supplement 2.. Mean age-specific cervical cancer incidence by cluster.
Figure 3.
Figure 3.. Sexual behaviour data from National AIDS Control Organization (NACO) by Indian state.
Indian state-specific data on (A) median age of first sex, (B) proportion of respondents reporting sex with non-regular partners in the last 12 months, (C) proportion of male respondents reporting sex with commercial partners in the last 12 months, and (D) proportion of male respondents by number of commercial partners in the last 12 months. Each violin plot and the associated cloud of circles correspond to a sexual behaviour variable. Each circle corresponds to the data of a state (or group of states). The data were extracted from the 2006 National Behaviour Surveillance Survey of the National AIDS Control Organization of India (National Behavioural Surveillance Survey: General Population, 2006). Blue and red: Indian states identified in the high and low cervical cancer incidence clusters. Grey: states without cervical cancer incidence data and therefore unknown cluster.
Figure 3—figure supplement 1.
Figure 3—figure supplement 1.. Indian state-specific sexual behaviour data from National AIDS Control Organization (NACO).
States or groups of states as reported in the 2006 National Behaviour Surveillance Survey of the National AIDS Control Organization of India. Other North Eastern states include Arunachal Pradesh, Nagaland, Meghalaya, Mizoram, and Tripura.
See this image and copyright information in PMC

Update of

  • doi: 10.1101/2022.06.28.22276994

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