Cervical cancer in Saudi Arabia : trends and regional disparities in incidence and survival

Abstract

In many countries, recent improvements in cervical cancer survival have mostly been modest. However, survival needs to be interpreted in the context of incidence and mortality in order to assess progress in cancer control. Further, survival by stage could help distinguish whether lower-than-expected survival is due to late-stage diagnosis or suboptimal management, and to inform health policy. Data on all women diagnosed with invasive cervical cancer during 2005-2016 were obtained from the Saudi Cancer Registry. Vital status and date of death if dead were ascertained by linking the registry records to vital registration data in the Ministry of Interior. Population counts by calendar year, sex, 5-year age group, region and nationality were obtained from the General Authority for statistics. Age-standardised incidence rates were calculated for women diagnosed during 2005- 2010 and 2011-2016. Age-standardised five-year net survival probabilities were estimated for the same periods by region and stage at diagnosis, and by region stratified by stage. Incidence rates were lower than in most countries, and changed very little between 2005- 2010 and 2011-2016 (1.66 to 1.76 per 100,000 women per year). Incidence was higher among non-Saudi than Saudi women, and in the three most populous regions. Age-standardised 5-year net survival did not change in Saudi Arabia between 2005-2010 (59.2; 95%CI 52.7-65.7) and 2011-2016 (59.7; 54.7-64.6), or in any of the regions, except in Makkah, where there was a 19% increase in survival for women diagnosed during 2011- 2016 compared to 2005-2010. Survival for women diagnosed at a distant stage was substantially lower in the Eastern Region than in other regions. Cervical cancer incidence and survival have remained largely unchanged. Despite very low incidence in Saudi Arabia, it is difficult to predict the future burden of cervical cancer. Higher survival could be achieved by improving early diagnosis and access to high-quality treatment.