Age-specific incidence and mortality of cervical cancer in the Czech Republic – analysis of nationwide data and data from a gynecologic oncology center

Abstract

Objective: To analyze the incidence and mortality of cervical cancer in individual age cohorts in the Czech Republic using nationwide data and data from the largest national gynecological oncology center. Materials and methods: Analysis of a single-institution cohort of newly treated cervical cancer cases from 2022–2024, and analysis of incidence and mortality trends in individual age groups using data from the Czech National Cancer Registry (ÚZIS – Institute of Health Information and Statistics) from 2000–2023. Results: The incidence and mortality of cervical cancer in the Czech Republic have declined significantly over the last 20 years. The decline correlates well with measures that have led to better organization and implementation of changes within the screening program. Analysis in individual age cohorts shows that the largest decline in incidence and mortality occurred in the cohort up to 34 years of age, yet in more than 50% of women with carcinomas in this cohort, cytological screening and subsequent management failed. The upward trend in incidence in the 35–44 and 45–54 age cohorts raises questions about the causes. The high percentage of invasive carcinomas in women examined by a gynecologist in the last three years requires an analysis of the quality of cytology laboratories and management by registering gynecologists. The introduction of high-risk human papillomavirus (HR HPV) testing and referral to expert colposcopy for discrepant findings is one way to improve the situation. Furthermore, audits of diagnosed carcinomas in women who have undergone screening should be introduced. The biggest challenge will be to activate the resistant population of women who underestimate the importance of regular screening examinations. Conclusion: Even though we can see an overall decline in incidence and mortality, when individual age cohorts are analyzed, it shows us ways for improvement in each specific age group of women individually.