Cervical Cancer in Khon Kaen, Thailand: Analysis of 1990-2014 Incidence Data and Prediction of Future Trends

Document Type : Research Articles


1 Doctor of Philosophy Program in Epidemiology and Biostatistics, Faculty of Public Health, Khon Kaen University, Thailand.

2 ASEAN Cancer Epidemiology and Prevention Research Group, Khon Kaen University, Thailand.

3 Department of Epidemiology and Biostatistics, Faculty of Public Health, Khon Kaen University, Thailand.


Background: Cervical cancer is the second most common cancer of women in Thailand. There have been no reports
of incidence and future in Khon Kaen, a province in northeastern Thailand, where the relatively high prevalence gives
evaluation of cervical cancer screening a high priority. Objectives: To determine cervical cancer incidence rates in
Khon Kaen for 1990–2014 and predict future trends until 2029. Methods: Cancer incidence data from the Khon Kaen
population-based cancer registry were analyzed and age-standardized incidence rates (ASR) were estimated. Joinpoint
analysis and age-period-cohort modeling were applied for data from 1990 to 2014 and the Nordpred package was
employed to project trends from 2015 to 2029. Results: Between 1990 and 2014, a total of 3,258 cases were diagnosed
with ICD-O code C53 (invasive cervical cancer). Before 2005, an annual percentage change (APC) varied widely, with
outliers in 1993 and 1999. The APC computed with the Joinpoint software decreased at -2.8% (95% CI;-4.5 to -1.1)
per year on average. After 2005, a rise was noted until 2008, after which a drop became apparent with an APC of
-8.0% (95% CI; -14.5 to -1.1) per year on average. Both period and cohort effects played a role in shaping the decrease
in incidence. The three projection method suggested that incidence rates would continue to decrease in the future.
Conclusions: A decreasing trend in incidence of cervical cancer in Khon Kaen was noted from 1990 to 2014 with a
prediction of continuous decrease until 2029. Maintenance and improvement of the screening program is advised.


Main Subjects