Trends in cervical cancer incidence--Indian scenario.

Cancer of the uterine cervix is the second most common cancer among women in the world after breast cancer. It is the most common cancer among Indian women. The present communication reports the trends in the incidence rate of cervical cancer for the Indian population. The data published in Cancer Incidence in Five Continents for various Indian registries for different periods and/or publication by the individual registry served as the source material. During the years 1990-1997, the age-adjusted incidence rates (AAR) for cervical cancer varied from 10.9 to 65.4 amongst various registries. The highest incidence was noted in the Ambillikai registry. The age-specific incidence rates (ASIR) for cervical cancer revealed that the disease increases from 35 years and reaches a peak between the ages 55 to 64 years. The trend analysis by period showed a decreasing trend in the incidence rate of cervical cancer in all the registries. However, the decrease was very small. The mean annual percentage decrease in the AAR ranged from 0.9 to 2.6% amongst various registries. Analysis of the data by ASIR revealed that the mean annual percentage decrease was higher for women in earlier age groups in most of the registries. For women beyond 64 years, the disease incidence showed an increasing trend or minimal decrease. It was also noted that most of the cervical cancer cases were detected with regional spread of the disease and a very small proportion were diagnosed at a localized stage. In India, an organized mass-screening programme with Pap smear for early detection of cervical cancer is not in practice. The data suggest an urgent need for initiation of community screening and educational programmes for the control and prevention of cervical cancer.