Cervical Cancer Prevalence, Incidence and Mortality in Low and Middle Income Countries: A Systematic Review

Document Type: Systematic Review and Meta-analysis

Authors

1 Nepal Development Society, Chitwan, Nepal.

2 1Nepal Development Society, Chitwan, Nepal .

3 Global Health Research Center, Duke Kunshan University, Kunshan, China.

4 3Research Unit for General Practice, Department of Public Health, Bartholins Alle 2, 1260, Aarhus University, Aarhus C 8000, Denmark.

5 Center for Global Health, Department of Public Health, Bartholins Alle 2, 1260, Aarhus University, Aarhus C 8000, Denmark.

Abstract

Introduction: Cervical cancer rates vary across the world, being highest in Eastern Africa (including Zimbabwe) and
lowest in Western Asia. It is the second most common type of cancer in women in the South East Asia region and a
major cause of cancer deaths among women of low and middle income countries (LMICs) like Nepal. This review
is an attempt to make a comprehensive report of prevalence, incidence and mortality of cervical cancer in LMICs.
Methods: The review was conducted applying a computerized search with the Medical Subject Heading (MeSH) major
topics “Cervical Cancer”, “Cervical neoplasm” “Epidemiology”, (“prevalence” OR “incidence” OR “mortality”) and
“HPV” OR “Human papillomavirus” as MeSH subheading. The search limits were: language (“English”), LMICs,
dates (articles published from “1st January 2000 to 31st December 2015”), and species (“Humans”). The search was
supplemented by cross-referencing. Publications that met the inclusion criteria were included in the synthesis. Results:
Among the 20 studies reviewed; seven were from Africa, seven from Asia, three from South America, and one each
from North America, Europe and Oceania. The review found the highest reported age standardized incidence rate as
17.9/100,000/year in Zimbabwe in 2000 and the lowest as 0.11/100,000/year in China in 2006. One study of Nigeria
revealed a cervical cancer prevalence of 5.0 per 1,000 in 2012 in the 25-64 year age group. Further, the highest reported
age standardized mortality rate was 16/100,000/year in India in 2015 and the lowest 1.8/100,000/year in Colombia in
2013. In addition, coitarche, tobacco smoking, number of sexual partners and family history of cervical cancer were
reported as significant risk factors. Conclusion: The study provides a review of reported prevalence, incidence and
mortality of cervical cancer in LMICs from 1st January 2000 to 31st December 2015. The scarcity of information
reveals a substantial need for further studies on cervical cancer prevalence, incidence and mortality with associated
risk factors in LMICs.

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