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

Abstract

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