Trends in cervical cancer incidence and mortality in Bulgaria, Estonia, Latvia, Lithuania and Romania.
OBJECTIVE
The burden of cervical cancer varies considerably in the European Union. In this paper, we describe trends in incidence of and mortality from this cancer in the five most affected member states.


METHODS
Data on number of deaths from uterine cancers and the size of the female population of Estonia, Latvia, Lithuania, Bulgaria and Romania were extracted from the WHO mortality database. Mortality rates were corrected for inaccuracies in the death certification of not otherwise specified uterine cancer. Incidence data were obtained from the national cancer registries. Joinpoint regression was used to study the annual variation of corrected and standardized incidence and mortality rates. Changes by birth cohort were assessed for specific age groups and subsequently synthesized by computing standardized cohort incidence/mortality ratios.


RESULTS
Joinpoint regression revealed rising trends of incidence (in Lithuania, Bulgaria and Romania) and of mortality (in Latvia, Lithuania, Bulgaria and Romania). In Estonia, rates were rather stable. Women born between 1940 and 1960 were at continuously increasing risk of both incidence of and mortality from cervical cancer.


CONCLUSIONS
Rising trends of cervical cancer in the most affected EU member states reveal a worrying pattern that warrants urgent introduction of effective preventive actions as described in the European guidelines.
Unit of Cancer Epidemiology Scientific Institute of Public Health, Brussels, Belgium. marc.arbyn@wiv-isp.be
Marc
M
Arbyn
Jerome
J
Antoine
Zdravka
Z
Valerianova
Margit
M
Mägi
Aivars
A
Stengrevics
Giedre
G
Smailyte
Ofelia
O
Suteu
Andrea
A
Micheli
D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D002031:Bulgaria / Q000453:epidemiology; D004957:Estonia / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D007844:Latvia / Q000453:epidemiology; D008097:Lithuania / Q000453:epidemiology; D008403:Mass Screening; D008875:Middle Aged; D012383:Romania / Q000453:epidemiology; D015996:Survival Rate; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology* / Q000401:mortality / Q000517:prevention & control