Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Aug 30;13(17):2169.
doi: 10.3390/healthcare13172169.

Spatial-Temporal Trends of Cancer Among Women in Central Serbia, 1999-2021: Implications for Disaster and Public Health Preparedness

Emina Kričković  1 , Vladimir M Cvetković  2   3   4 , Zoran Kričković  5 , Tin Lukić  6   7
Affiliations

Spatial-Temporal Trends of Cancer Among Women in Central Serbia, 1999-2021: Implications for Disaster and Public Health Preparedness

Emina Kričković et al. Healthcare (Basel). .

Abstract

Background/objectives: Cancer is a major public health burden in Serbia and a factor influencing long-term disaster readiness by straining health system capacity. This study examined spatial and temporal trends in incidence and mortality for eight major cancers among women in Central Serbia (1999-2021) to inform targeted prevention and preparedness strategies.

Methods: Standardised rates from national datasets were analysed using the Mann-Kendall trend test and Sen's slope estimator. Geographic disparities were mapped in ArcGIS Pro 3.2. Mortality trends were assessed only for statistically reliable series.

Results: Breast cancer incidence increased in six counties, while cervical cancer declined in several areas, likely reflecting screening success. Colorectal, bladder, pancreatic, and lung and bronchus cancers showed rising incidence; lung and bronchus cancer mortality increased in 16 counties, indicating growing demand for chronic respiratory care. These shifts may reduce surge capacity during disasters by increasing the baseline burden on healthcare infrastructure. Regional disparities highlight uneven system resilience.

Conclusions: Aligning cancer control measures-especially for high-burden cancers like lung-with emergency preparedness frameworks is essential to strengthen health system resilience, particularly in resource-limited regions.

Keywords: Mann–Kendall Test; bladder; breast; cervical; colorectal; emergency preparedness; lung and bronchus cancers; ovarian; pancreatic; uterine.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Schematic representation of the research process.
Figure 2
Figure 2
Mann–Kendall analysis of breast cancer incidence rates.
Figure 3
Figure 3
Mann–Kendall analysis of breast cancer mortality rates.
Figure 4
Figure 4
Mann–Kendall analysis of cervical cancer incidence rates.
Figure 5
Figure 5
Mann–Kendall analysis of cervical cancer mortality rates.
Figure 6
Figure 6
Mann–Kendall analysis of lung and bronchus cancer incidence rates.
Figure 7
Figure 7
Mann–Kendall analysis of lung and bronchus cancer mortality rates.
Figure 8
Figure 8
Mann–Kendall analysis of ovarian cancer incidence rates.
Figure 9
Figure 9
Mann–Kendall analysis of ovarian cancer mortality rates.
Figure 10
Figure 10
Mann–Kendall analysis of uterine cancer incidence rates.
Figure 11
Figure 11
Mann–Kendall analysis of pancreatic cancer incidence rates.
Figure 12
Figure 12
Mann–Kendall analysis of pancreatic cancer mortality rates.
Figure 13
Figure 13
Mann–Kendall analysis of bladder cancer incidence rates.
Figure 14
Figure 14
Mann–Kendall analysis of colorectal cancer incidence rates.
Figure 15
Figure 15
Mann–Kendall analysis of colorectal cancer mortality rates.
Figure 16
Figure 16
Map of the MK incidence rates analysis for: (a) Breast, (b) Cervical, (c) Uterine, (d) Colorectal, (e) Bladder, (f) Ovarian, (g) Pancreatic, and (h) Lung and bronchus cancer.
Figure 17
Figure 17
Map of the MK mortality rates analysis for (a) Breast, (b) Cervical, (c) Colorectal, (d) Ovarian, (e) Pancreatic and (f) Lung and bronchus cancer.
See this image and copyright information in PMC

References

    1. Cvetković V.M., Nikolić N., Ocal A., Martinović J., Dragašević A. A Predictive Model of Pandemic Disaster Fear Caused by Coronavirus (COVID-19): Implications for Decision-Makers. Int. J. Environ. Res. Public Health. 2022;19:652. doi: 10.3390/ijerph19020652. - DOI - PMC - PubMed
    1. Cvetković V., Tanasić J., Ocal A., Živković-Šulović M., Ćurić N., Milojević S., Knežević S. The Assessment of Public Health Capacities at Local Self-Governments in Serbia. Lex Localis J. Local Self-Gov. 2023;21:1201–1234. doi: 10.4335/21.4.1201-1234(2023). - DOI
    1. Cvetković V.M., Nikolić N., Nenadić U.R., Öcal A., Noji E.K., Zečević M. Preparedness and Preventive Behaviors for a Pandemic Disaster Caused by COVID-19 in Serbia. Int. J. Environ. Res. Public Health. 2020;17:4124. doi: 10.3390/ijerph17114124. - DOI - PMC - PubMed
    1. Cvetković V.M., Tanasić J., Ocal A., Kešetović Ž., Nikolić N., Dragašević A. Capacity Development of Local Self-Governments for Disaster Risk Management. Int. J. Environ. Res. Public Health. 2021;18:10406. doi: 10.3390/ijerph181910406. - DOI - PMC - PubMed
    1. Cvetković V.M., Tanasić J., Renner R., Rokvić V., Beriša H. Comprehensive Risk Analysis of Emergency Medical Response Systems in Serbian Healthcare: Assessing Systemic Vulnerabilities in Disaster Preparedness and Response. Healthcare. 2024;12:1962. doi: 10.3390/healthcare12191962. - DOI - PMC - PubMed

LinkOut - more resources