Trends in cervical cancer mortality rates in Lithuania, 1987-2016

Background: The aim of this study was to investigate time trends in cervical cancer mortality rates in Lithuania across age groups and time periods over a 30-year time span.

Methods: Data on numbers of deaths from cervical cancer during the period 1987-2016 were obtained from the WHO mortality database. Trends in age-standardised mortality rates (ASR, world standard), and age-specific rates were analysed by calculating annual percentage change (APC) using Joinpoint regression. In addition, age-period-cohort analysis was performed.

Results: Joinpoint regression analysis indicated that mortality from cervical cancer increased by 2.0% (95% CI: 1.2, 2.9) annually from 1987 to 2002 and decreased by 2.3% (95% CI: 3.2, 1.3) annually thereafter. In age groups 20-39 and 40-49 years after a sharp increase by 5.6% (95% CI: 2.6, 8.7) and 5.9% (95% CI: 2.7, 9.2), respectively, mortality rates declined since around 2000 with slopes of -4.8% (95% CI: -7.6, -1.9) and -2.7% (95% CI: -4.7, -0.6), respectively. Among women aged 50-59 years there was an increase in mortality (APC = 2.6%; 95% CI: 0.8, 4.5) followed by decrease with a not statistically significant slope (APC = -2.2%; 95% CI: -5.1, 0.7) since 2004. For older women mortality rates moderately declined during the entire time span. The age-period-cohort analysis suggests that temporal trends in cervical cancer mortality rates could be attributed to period and cohort effects.

Conclusions: Opportunistic screening may have contributed to favourable recent changes in cervical cancer mortality rates in Lithuania, however not to the extent seen in most European countries.