Recent Epidemiologic Trends in Cervical Cancer

Understanding the recent global pattern and trends in cervical cancer burden could enable us to prevent and control this condition. First, we reviewed cervical cancer incidence and mortality according to the human development index (HDI) and geographical region. More than 80% of cancer cases and deaths occurred in areas with a lower or middle level of development. In addition, a remarkable geographic contrast in cervical cancer burden was observed. The highest incidence and mortality were observed in Eastern, Southern and Middle Africa, due to a lack of awareness of disease symptoms, limited access to appropriate prevention and medical services, and the concomitant human immunodeficiency virus (HIV) epidemic in this region. Next, we reviewed sexual behavior, immunodeficiency disorders owing to HIV infection, history of sexually transmitted infection, tobacco smoking, endogenous and exogenous hormonal factors as risk factors associated with acquiring human papillomavirus (HPV) infection, and impaired immune response to HPV infection and progression of cervical intraepithelial neoplasia (CIN). Although HPV is a main etiological factor in cervical carcinogenesis, the noteworthy geographic contrast might also be attributable to exposure to these risk factors and inequalities in access to the healthcare system. Eliminating cervical cancer requires—in addition to HPV vaccination, screening and treatment—consideration of lifestyle modification, including tobacco control, sexual education, and HIV control.