title: Time trends in the incidence of cancer cervix in Karachi South, 1995-2002.
abstract: BACKGROUND
  The objective of the study was to determine the trends of cancer cervix in Karachi South during an eight (1995-2002) year period.
  
  
  METHODS
  Cancer cervix cases recorded at Karachi Cancer Registry during 1st January 1995 to 31st December 2002 were analyzed. Trends were studied by analyzing the age standardized incidence rates (ASR)s in 2 time periods, 1995-97 and 1998-2002.
  
  
  RESULTS
  Cancer cervix ranked sixth in the 1995-97 period the age standardized incidence rate (ASR) world and crude incidence rate (CIR) per 100,000 were 6.81 and 3.22. It reached the fifth ranking in the 1998-2002 period with an ASR and CIR of 7.5 and 4.0 per 100,000. Thus between 1995 and 2002, the incidence of cervical cancer registered an approximate 10% increase. The mean age of the cancer cases was 53.3 years (SD 11.6; 95% CI 50.58, 55.96; range 32-85 years) and 50.7 years (SD 11.7; 95% CI 48.8, 52.5; range 51 years) in period 1 and 2 respectively. The morphological components of squamous cell carcinoma and adenocarcinoma remained stable during this period, though a marginally higher component and increasing incidence of adenocarcinoma was observed throughout. A negligible down staging was observed in the 1998-2002 period. Localized malignancy was observed in 30.8% in period 2 as compared to 25.7% in period 1 and the component of carcinoma in situ increased from 0% percent in period 1 to 1.3% in the second period. Despite this two thirds of the cases still presented with a regional or distant spread of disease.
  
  
  CONCLUSIONS
  Pakistan at present falls into a low risk cancer cervix region. The cause of concern is the steadily increasing incidence especially in the younger birth cohorts, the advanced disease at presentation; insignificant in-situ cancers and no preventive intervention or awareness practices in place.
authors.affiliation: Karachi Cancer Registry, Department of Pathology and Microbiology, Aga Khan University Hospital, Karachi, Pakistan. bhurgri@cyber.net.pk
authors.forename: Yasmin
authors.initials: Y
authors.lastname: Bhurgri
authors.forename: Shahid
authors.initials: S
authors.lastname: Pervez
authors.forename: Naila
authors.initials: N
authors.lastname: Kayani
authors.forename: Muneeza
authors.initials: M
authors.lastname: Afif
authors.forename: Imran
authors.initials: I
authors.lastname: Tahir
authors.forename: Kauser
authors.initials: K
authors.lastname: Nazir
authors.forename: Ahmed
authors.initials: A
authors.lastname: Usman
authors.forename: Naveen
authors.initials: N
authors.lastname: Faridi
authors.forename: Hadi
authors.initials: H
authors.lastname: Bhurgri
authors.forename: Jawaid
authors.initials: J
authors.lastname: Malik
authors.forename: Imtiaz
authors.initials: I
authors.lastname: Bashir
authors.forename: Asif
authors.initials: A
authors.lastname: Bhurgri
authors.forename: Rashida
authors.initials: R
authors.lastname: Ahmed
authors.forename: Sheema H
authors.initials: SH
authors.lastname: Hasan
authors.forename: Mohammed
authors.initials: M
authors.lastname: Khurshed
authors.forename: S M H
authors.initials: SM
authors.lastname: Zaidi
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D003906:Developing Countries; D005260:Female; D006801:Humans; D015994:Incidence; D009361:Neoplasm Invasiveness / Q000473:pathology*; D009367:Neoplasm Staging; D010154:Pakistan / Q000453:epidemiology; D012042:Registries; D012189:Retrospective Studies; D018570:Risk Assessment; D016019:Survival Analysis; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology* / Q000208:ethnology / Q000473:pathology*