Cervical cancer epidemiology in high-income nations (1990-2023): Three decades of prevention success and emerging disparities.

Abstract

e17532 Background: Cervical cancer rates and deaths have dropped significantly in high-income countries after the start of organized screening programs and the rollout of human papillomavirus (HPV) vaccines. Still, the impact of the disease varies by region. Recent changes in epidemiology indicate a need to review long-term trends and the effectiveness of prevention efforts in these areas. Methods: We looked at data from the Global Burden of Disease (GBD) 2023 study for 59 high-income countries and territories (sociodemographic index greater than 0.80). We focused on outcomes such as incidence, mortality, disability-adjusted life years (DALYs), and age-standardized rates. We divided the analyses by age (15–49 years, 50 years and older) and by time period: pre-vaccination (1990–2006), early vaccination (2007–2015), and widespread vaccination (2016–2023). We used joinpoint regression to assess trends over time and to find significant changes. Results: In 2023, high-income regions reported about 45,200 to 52,800 new cervical cancer cases. This accounted for 12.8% of global cases, even though these regions only make up 16% of the global female population. Age-standardized incidence rates were between 6.2 and 7.8 per 100,000, showing significant regional differences. Nordic countries had the lowest rates at 3.1 to 3.8 per 100,000, while Central and Eastern Europe had rates more than double that, highlighting gaps in HPV vaccine coverage and screening access. Annual deaths ranged from 13,500 to 15,900. Age-standardized mortality rates declined by an average of 2.8% per year since 1990, which is a greater decline than the global average. Cervical cancer caused 485,000 to 612,000 DALYs, with nearly three-quarters due to early deaths. Incidence fell slightly before vaccination began, increased after the introduction of vaccines, and showed the steepest decrease after 2016 as vaccinated groups moved into higher-risk age ranges. Conclusions: High-income countries have made significant strides in reducing the burden of cervical cancer. However, major differences remain across regions and populations. Improving HPV vaccine uptake, expanding primary HPV-based screening, and enhancing access for underserved groups are crucial steps toward eliminating cervical cancer.