SPATIAL ANALYSIS OF CERVICAL CANCER INCIDENCE IN IRAQ DURING 2010-2015

Cervical cancer is the most common cancer in Iraq. This study aimed to examine the spatial pattern and high-risk clusters of cervical cancer in different areas of Iraq (except the Kurdish region) during the period 2010-2015. The age-adjusted incidence rates (AAIRs), age-specific incidence rates (ASIRs), and annual percent changes (APCs) were calculated for 2010–2015. We used three techniques of spatial statistical analysis which are Global spatial autocorrelation, Getis-Ord Gi* statistic, and Anselin Local Moran’s statistic to investigate spatial clustering and outliers. Over the period 2000-2015, 1037 cases were diagnosed with AAIR of incidence of (3.521 per 100,000). Depending on AAIRs, we found cervical cancer incidence was highest (8.212 per 100,000) in the age group of 60-69 years old. The APC of cervical cancer age-specific rates has significantly risen for the age groups 60-69 only. We identified spatial high-risk clusters for incidence. The cluster was mainly located in the center of Iraq (Baghdad, Najaf, Kerbala, and Babil provinces), the central-eastern part of Iraq (Diyala province), and the southern part of Iraq (Basrah province). While the provinces in the northern and northeastern parts of Iraq, as well as the western province, had relatively lower AAIRs from cervical cancer. A spatial cluster pattern for the incidence of cervical cancer in Iraq was revealed, which will be valuable for improving the allocation of health resources in Iraq.

Cáncer de cuello uterino. Incidencia registrada en el Hospital “Dr. Domingo Luciani” en el año 2020

Objective: To estimate the incidence of cervical cancer (CCU) in the year 2020 in the gynecology oncology consultation of the Obstetrics and Gynecology Service of the Hospital “Dr. Domingo Luciani”. Method: Retrospective, descriptive study, where the clinical histories of the patients diagnosed with cervical cancer who attended the first oncology gynecology consultation were reviewed, the period from January to December 2020. Results: Sixty patients met the inclusion criteria, the variables studied were age, histological type, stage at the time of diagnosis and indicated treatment;14.52% were diagnosed with cervical cancer; the mean age at the time of diagnosis was 43.15 years; the most common histological group was squamous, (96.67%). Regarding staging, 28 cases (46.67%) were diagnosed in stage IIIB, 14 cases (23.33%) in stage IIB, and only 6.66% were diagnosed in early stages. Treatment indicated radiotherapy and chemotherapy. Conclusion: We show in the present study that cervical cancer represents a significant percentage of gynecological consultations, that unfortunately the diagnosis is made in advanced stages, negatively affecting the prognosis of these patients and that the age at which it predominates is in full productive life of the women. affected women, constituting a real public health problem and chaos for families and society. Keywords: Cervical cancer, Incidence, Carcinoma, Adenocarcinoma, Stage

Disparities in the Increases of Cervical Cancer Incidence Rates: Observations from a City-wide Population-based Study

Background: Globally cervical cancer incidence rate has been declining continuously. However, an unfavorable trend has been observed in China during the past decades, and the underlying reasons remain unclear. We hereby explore the recent trends of cervical cancer incidence, as well as the underlying determinants using data from Guangzhou, one of biggest cities in China. Methods：City-wide cancer registration data were obtained from the Guangzhou Center for Disease Prevention and Control from 2004 to 2018. We used the Joinpoint regression models to estimate the average annual percentage change (AAPC) of age-standardized and age-specific incidence rates by regions and by histological subtype. Age-period-cohort models were applied to analyze the period and birth cohort effects on the time trends. Results: The age-standardized rates (ASRs) of cervical cancer incidence increased at an annual rate of 2.1% [95% confidence interval (CI): 1.0%-3.2%] during 2004-2018. The largest increase in ASRs was found for rural regions, with AAPC of 6.6% [95% CI: 3.7%-9.5%], followed by the suburbs (2.2% [95% CI: 1.0%-3.4%]), while there was no statistically significant increase in urban regions. The ASRs of adenocarcinoma increased faster than those of the squamous cell carcinoma (AAPC=6.53% [95% CI: 5.0%-8.1%] versus 1.79% [95% CI: 0.8%-2.8%]). A downward trend in urban regions was found in the 20-49 age group, whereas an upward trend was found in the 50+ age group, especially in rural regions. An inverted V-shape was found for cohort effects, with the peak varied by regions, i.e., peaked in the 1966 and 1971 birth cohort in the urban and suburb regions, respectively. Period effects kept increasing during the study period. Conclusions: We systematically examine the disparities in the increases of cervical cancer incidence rates using city-wide data from Guangzhou. Extensive efforts are warranted to address the large urban-rural disparities in cervical cancer prevention. The combined strategies of vaccination, screening, and health education should be reinforced and locally customized.

The State of Cervical Cancer Screening and HPV Vaccination in Africa: In the Advent of Advanced Health Care

Cervical cancer if not detected and treated promptly can be lethal to females. In several advanced nations, the relevance of coordinated screening services has been implemented. Nevertheless, most developing nations have not implemented a nationwide screening and vaccination programme accessible to all women owing to inadequate screening and vaccination services coupled with vaccine scepticism, misconception concerning vaccination, and lack of awareness are causing an upsurge in Africa's cervical cancer cases. Cervical cancer could be greatly reduced if comprehensive screening services and HPV vaccination are implemented. In this review, we discussed the cervical cancer incidence in Africa, factors influencing the high rate of cervical cancer in Africa, screening and HPV vaccination programs and the potential intervention and recommendations to reduce the incident and mortality rates of cervical cancer in Africa. Also, we highlighted the disadvantages and advantages of widely accessible screening tests in Africa.