India sees most number of cervical cancer cases, deaths in Asia: Lancet

Lancet report titled, "Global estimates of incidence and mortality of cervical cancer in 2020: a baseline analysis of the WHO Global Cervical Cancer Elimination Initiative," highlights glaring reality

According to the latest Lancet report, more than 58 per cent of all cases of cervical cancer globally were estimated in Asia followed by Africa (20 per cent), Europe (10 per cent) and Latin America (10 per cent). The latest report titled, "Global estimates of incidence and mortality of cervical cancer in 2020: a baseline analysis of the WHO Global Cervical Cancer Elimination Initiative," highlights glaring reality of cervical cancer in world. 

As Asia reported the maximum number of cases across the world, India recoded the most number of cases and deaths due to cervical cancer among its Asian peers. The report states that 39 per cent of all cases occurred in China (18 per cent) and India (21 per cent) and 40 per cent of total deaths from cervical cancer (17 per cent in China; 23 per cent in India).

There were over 600,000 estimated new cervical cancer cases globally, and over 340,000 deaths.

The reported incidence was found to be way above than the WHO criteria of defining a disease as a public health problem in populous countries like China, India, Brazil and Russia. 

If 4 per 100,000 women were diagnosed with cervical cancer in a country then it becomes a public health problem, according to the WHO threshold This threshold was seen breached as China saw 10.7 cases per 100,000 women, India was at 18.0 cases, Indonesia at 24.4 cases, Russia at 14.1 cases, and Brazil recoded 12.7 cases per 100,000 women.

The report highlights that the targets to reach the WHO elimination threshold by 2030 are likely to be missed. Only if the countries scaled up screening programmes, improved coverage of human papillomavirus or HPV vaccination and improve access to affordable treatment, there is some hope to meet the 2030 target.

In the year 2020, rates of cervical cancer cases were 13 per 100,000 women per year and there were seven deaths per 100,000 women per year. Incidence rates in 172 out of 185 countries exceeded the four cases per 100,000 women per year.

"Globally in 2020, there were an estimated 604 127 cervical cancer cases and 341 831 deaths, with a corresponding age-standardised incidence of 13·3 cases per 100, 000 women-years (95 per cent CI 13·3–13·3) and mortality rate of 7.2 deaths per 100, 000 women-years (95 per cent CI 7·2–7·3)."

The trend data from 1988 to 2017, showed a major decline in cases in some Latin American countries, including Brazil, Colombia, and Costa Rica. A similar pattern was observed in Asia in India, Thailand, and South Korea, as well as in Eastern Europe in Poland, Slovenia, and Czechia. However, there was an increase in cases in Eastern Europe and Eastern Africa in the past decade.

"Between 1988 and 2017, major declines in incidence were observed in some Latin American countries, including Brazil, Colombia, and Costa Rica. A similar pattern was observed in Asia in India, Thailand, and South Korea, while incidence in Japan and China remained stable with a slight increase between 2007 and 2017. In Europe, incidence increased in Latvia, Lithuania, and Bulgaria, whereas incidence decreased in Poland, Slovenia, and Czechia. "

The report specifically raised concerns around the persistently high rates of cervical cancer in Low and Middle Income Countries (LMICs) and the recent increases in countries in Eastern Europe and sub-Saharan Africa.

The World Health Organization (WHO) had announced a target to accelerate the elimination of cervical cancer as a public health problem in 2020, with an aim to reduce incidence below a threshold of 4 cases per 100,000 women per year in every country by 2030. 

The Lancet study traces the progress on cervical cancer rates in the year 2020 and identifies problem areas that need to be redressed to achieve the 2030 target. It provides a comprehensive and up-to-date overview of the global, regional, and national patterns of cervical cancer in 2020, highlighting inequalities across geographical, socioeconomic, and temporal axes, and including the progress made at the country-and-region level in the previous three decades.