Population-based trends in cervical cancer incidence and net survival in Cyprus (2004-2017)

Abstract

Abstract   Cervical cancer (CC) remains a preventable yet persistent public health challenge in Cyprus, with particular concern for women of reproductive age. In a setting where HPV vaccination and screening have the potential to substantially reduce disease burden, understanding recent trends is essential for guiding prevention and care. We examined CC incidence and survival among women in Cyprus between 2004 and 2017. We analysed data from the Cyprus Cancer Registry for women aged 15 years and older diagnosed with CC during 2004 to 2017, with follow-up through 2019. Tumours were classified as local, regional, distant, or unknown according to SEER Summary Stage. Age-specific and European age-standardized incidence rates were calculated. Incidence trends were assessed using Joinpoint regression and expressed as annual percentage change (APC). Five-year net survival was estimated using a flexible parametric survival model adjusted for age, period of diagnosis, and stage at diagnosis. A total of 446 CC cases were recorded. Overall incidence increased significantly over the study period (APC = 1.8%, p = 0.046), with a steeper increase among women aged 15-49 years (APC = 3.2%, p = 0.048). No statistically significant changes were observed in other age groups or by stage at diagnosis. In contrast, survival improved over time. Five-year net survival rose from 75.3% during 2004-2008 to 82.8% during 2014-2017, with gains observed across all stages, particularly among women diagnosed with distant-stage disease. These findings highlight a concerning rise in CC incidence, especially among younger women, alongside encouraging improvements in survival. This pattern suggests advances in diagnosis and treatment, but prevention is not yet having sufficient population-level impact. Strengthening HPV vaccination uptake, improving participation in cervical screening, and ensuring timely access to care should be public health priorities in Cyprus. Key messages • Cervical cancer incidence increased in Cyprus between 2004 and 2017, with the sharpest rise seen among women aged 15 to 49 years. • Although survival improved over time, the findings highlight the need to strengthen HPV vaccination, screening, and timely access to care.