Proportions and incidence of locally advanced cervical cancer: a global systematic literature review.

BACKGROUND

Optimal treatment of cervical cancer is based on disease stage; therefore, an understanding of the global epidemiology of specific stages of locally advanced disease is needed.

OBJECTIVE

This systematic literature review was conducted to understand the global and region-specific proportions of patients with cervical cancer with locally advanced disease and to determine the incidence of the locally advanced disease.

METHODS

Systematic searches identified observational studies published in English between 2010 and June 10, 2020, reporting the proportion of patients with, and/or incidence of, locally advanced stages of cervical cancer (considered International Federation of Gynecology and Obstetrics (FIGO) IB2-IVA). Any staging criteria were considered as long as the proportion with locally advanced disease was distinguishable. For each study, the proportion of locally advanced disease among the cervical cancer population was estimated.

RESULTS

The 40 included studies represented 28 countries in North or South America, Asia, Europe, and Africa. Thirty-eight studies reported the proportion of locally advanced disease among populations with cervical cancer. The estimated median proportion of locally advanced disease among all cervical cancer was 37.0% (range 5.6-97.5%; IQR 25.8-52.1%); estimates were generally lowest in North America and highest in Asia. Estimated proportions of ≥50% were reported in nine studies from Asia, Europe, Brazil, and Morocco; estimates ≤25% were reported in six studies from Asia, United States, Brazil, and South Africa. Locally advanced disease was reported for 44% and 49% of women aged >70 and ≥60 years, and 5-100% of younger women with cervical cancer. A greater proportion of locally advanced disease was reported for Asian American (19%) versus White women (8%) in one United States study. Two of five studies describing the incidence of locally advanced disease reported rates of 2-4/100 000 women among different time frames.

CONCLUSION

This review highlights global differences in proportions of locally advanced cervical cancer, including regional variance and disparities according to patient race and age.

Informations de copyright

© IGCS and ESGO 2022. Re-use permitted under CC BY. Published by BMJ.

Déclaration de conflit d'intérêts

Competing interests: BJM reports personal fees from Abbvie, Advaxis, Agenus, Amgen, AstraZeneca, Biodesix, Clovis, Conjupro, Genmab, Gradalis, ImmunoGen, Immunomedics, Incyte, Janssen/Johnson & Johnson, Mateon (formally Oxigene), Merck, Myriad, Perthera, Pfizer, Precision Oncology, Puma, Roche/Genentech, Samumed, Takeda, TESARO, Inc., and VBL, outside the submitted work. DT is supported by grants from the Singapore Ministry of Health’s National Medical Research Council and Pangestu Family Foundation Gynaecological Cancer Research Fund. He also reports personal fees from AstraZeneca, Roche, MSD, Merck Serono, GSK, Tessa Therapeutics, Eisai, and Genmab; research funding and support from AstraZeneca, Roche, Bayer, BMS, MSD, Eisai, and Karyopharm; stock ownership in the Asian Microbiome Library (AMiLi). All of these have been received outside the submitted work. JT has nothing to disclose. ATN, JDHC, and MP are employees and shareholders of AstraZeneca. EP-L reports personal fees and non-financial support from AstraZeneca, Tesaro/GSK, Roche; personal fees from Clovis, Incyte, and Pfizer; and other from ARCAGY-Research, outside the submitted work.