By Dr Ananya Mandal, MD
In the United States of America
According to the Centers for Disease Prevention and Control (CDC), cervical cancer was once the leading cause of cancer death for women in the United States. In the last 4 decades the trends have changed for the better. The number of cases of cervical cancer and the number of deaths from cervical cancer have decreased significantly. This is mainly because more and more women get regularly screened with Pap tests that can detect cervical cancer in its precancerous and in early stages. The death rate from cervical cancer continued to decline until 2003. Since then it has remained stable in white women, but has gone down in African American women.
In 2008, 12,410 women in the United States were diagnosed with cervical cancer and 4,008 women died from cervical cancer. According to the American Cancer Society's most recent estimates in 2012 about 12,170 new cases of invasive cervical cancer will be diagnosed and around 4,220 women will die from cervical cancer.
The ACS also estimates that non-invasive cervical cancer (carcinoma in situ) occurs about 4 times more often than invasive cervical cancer. While Hispanic women are most likely to get cervical cancer, followed by African-Americans, Asians and Pacific Islanders, and whites, American Indians and Alaskan natives have the lowest risk of cervical cancer.
In the United Kingdom
The trends in the UK are similar to those in USA and for similar reasons according to Cancer Research UK. In 2009, 3,378 women in the UK were diagnosed with cervical cancer and in 2010 there were 936 deaths from cervical cancer in the UK. It has been seen that between 2005 and 2009 67% of women in UK have survived their cervical cancer for five years or more.
In the UK, cervical cancer is the 19th most common cancer and accounts for 1% of all new cases. Cervical cancer is the 11th most common cancer among women in the UK, accounting for around 2% of all new cases of cancer in females. The cancer is significantly higher in Northern Ireland compared with England. Around 76% of cervical cancer cases occur in 25-64 year olds. Screening between these age groups is thus most beneficial.
Cervical cancer incidence rates have decreased since the 1980s following the introduction of the national NHS cervical screening programmes around the UK in 1988. Rates decreased by 49% in Great Britain from their peak in 1985-1987. The lowest rates were seen in 2002-2004 at 8.4 per 100,000 women.
In Australia, there were 734 cases of cervical cancer in 2005 and the number of women diagnosed with cervical cancer has dropped on average by 4.5% each year since organised screening began in 1991. There were 778 new cases in Australia in 2008 compared with 1,092 detected in 1991.
The most recent statistics on the National Cervical Screening Program published in Cervical Screening in Australia show that in 2009-2010, 3,792,517 Australian women had Pap smears. Of these 3,635,929 (95.9%) were in the target age group 20-69 years. In 2010 the National Cervical Screening Program detected 20,104 women in the target age group with abnormal Pap smears. Death rates with cervical cancer have also declined from 3.9 deaths per 100,000 women in 1991 to 1.9 deaths per 100,000 women in 2007.
Worldwide, cervical cancer is the third most common cancer in women and the seventh most common overall (in both sexes combined). In 2008 there were 530,000 new cases of cancer.
Cervical cancer incidence rates are lowest in Western Asia and highest in Eastern Africa. This geographical variation can be attributed to differences in prevalence of HPV, and other co-factors that modify risk in HPV-infected women. This includes use of oral contraception and smoking prevalence.
Screening programmes have substantially reduced incidence and mortality rates in Western countries. HPV vaccination in addition has also served to reverse the trends.
Reviewed by April Cashin-Garbutt, BA Hons (Cantab)