Epidemiology of cervical cancer in Colombia

Abstract

Worldwide, cervical cancer is the third most common cancer in women, and the first or second most common in developing countries. Cervical cancer remains in Colombia the first cause of cancer mortality and the second cause of cancer incidence among women, despite the existence of screening programs during the last 3 decades. Bucaramanga, Manizales and Cali reported rates around 20 per 100,000and Pasto 27 per 100,000. The Cali cancer registry has reported a progressive decrease in the age standardized incidence and mortality rates of cervical cancer over the past 40 years. Reasons for the decline in incidence and mortality of cervical cancer are multiple and probably include: improvement in socio-economic conditions, decrease in parity rates and some effect of screening programs. Human papilloma Virus is the main cause of cervical cancer, HPV natural history studies have now revealed that HPVs are the commonest of the sexually transmitted infections in most populations. Most HPV exposures result in spontaneous clearance without clinical manifestations and only a small fraction of the infected persons, known as chronic or persistent carriers, will retain the virus and progress to precancerous and cancer. HPV 16 and 18 account for 70% of cervical cancer and the 8 most common types. (HPV 16, 18, 45, 33, 31, 52, 58 and 35) account for about 90% of cervical cancer. Case-control studies also allowed the identification of the following cofactors that acting together with HPV increase the risk of progression from HPV persistent infection to cervical cancer: tobacco, high parity, long term use of oral contraceptives and past infections with herpes simplex type 2 and Chlamydia trachomatis. The demonstration that infection with certain types of human papillomavirus (HPV) is not only the main cause but also a necessary cause of cervical cancer has led to great advances in the prevention of this disease on two fronts: (i) Primary prevention by the use of prophylactic HPV vaccines; and (ii) secondary prevention by increasing the accuracy of cervical cancer screening.

Trends of Cervical Cancer in Ethiopia

“…Contrarily, several reports in countries of North America [14], Latin America [15], and Asia [16] show a decreasing incidence rate and cervical cancer mortality was stable or slightly decrease during period analysed [17]. The highest age group of the patients was 40-49 years which is similar to studies done in Nigeria & USA on black populations and other parts of sub-Saharan Africa [18].…”

Cervical Cancer Trends in Mexico: Incidence, Mortality and Research Output

“…The main finding of the study is that the incidence rate has decreased over the period of last five years. Similarly, several reports in countries of North America (Mosavi-Jarrahi and Kliewer, 2013; Adegoke et al, 2012), Latin America (Muñoz and Bravo, 2012), and Asia (Jung et al, 2014) show a decreasing incidence rate.…”

Mortality due to cervical cancer, 1996-2011, Santa Catarina, Brazil

“…[22][23][24] Risk factors for cervical cancer related to HPV include early sexual initiation, type of contraceptive methods, the prolonged use of oral contraceptives, greater number of children, multiple partners, low socioeconomic level, and smoking. 6,25 Vaccines against HPV are 99% efficient in preventing pre-cancerous lesions associated with HPV in young women. Vaccination campaigns against HPV in other countries produced a significant decrease in the prevalence of HPV, which translates into decreased future rates of CCU.…”

“…[3][4][5] Cervical cancer is the main cause of death due to cancer in Colombia, with regional mortality rates ranging from 20.0 to 27.0/100,000 women. 6 Brazil follows the world trend in which cervical cancer is the third main cause of death due to cancer among women. 7 Differences among countries suggest that guidelines concerning early detection strategies, such as the Pap smear exam, need to take into account regional contexts.…”