National cervical cancer burden estimation through systematic review and analysis of publicly available data in Pakistan

Authors

Novera G. Chughtai, Aga Khan UniversityFollow
Kausar Perveen, Aga Khan University
Sehar Rahim Gillani, Aga Khan University
Aamir Abbas, Aga Khan UniversityFollow
Afshan Anwar, Aga Khan UniversityFollow
Salima Karani, Aga Khan UniversityFollow
Ali Aahil Noorali, Aga Khan UniversityFollow
Maheen Zakaria, Aga Khan UniversityFollow
Uzma Shamsi, Aga Khan UniversityFollow
Uzma Chishti, Aga Khan UniversityFollow
Sajid Bashir Soofi, Aga Khan UniversityFollow
Shahid Pervez, Aga Khan UniversityFollow
Zainab Samad, Aga Khan UniversityFollow

Document Type

Article

Department

Obstetrics and Gynaecology; Medicine; Paediatrics and Child Health; Medical College Pakistan; Community Health Sciences; Pathology and Laboratory Medicine

Abstract

Background: Cervical cancer is a major cause of cancer-related deaths among women worldwide. Paucity of data on cervical cancer burden in countries like Pakistan hamper requisite resource allocation.
Objective: To estimate the burden of cervical cancer in Pakistan using available data sources.
Methods: We performed a systematic review to identify relevant data on Pakistan between 1995 to 2022. Study data identified through the systematic review that provided enough information to allow age specific incidence rates and age standardized incidence rates (ASIR) calculations for cervical cancer were merged. Population at risk estimates were derived and adjusted for important variables in the care-seeking pathway. The calculated ASIRs were applied to 2020 population estimates to estimate the number of cervical cancer cases in Pakistan.
Results: A total of 13 studies reported ASIRs for cervical cancer for Pakistan. Among the studies selected, the Karachi Cancer Registry reported the highest disease burden estimates for all reported time periods: 1995-1997 ASIR = 6.81, 1998-2002 ASIR = 7.47, and 2017-2019 ASIR = 6.02 per 100,000 women. Using data from Karachi, Punjab and Pakistan Atomic Energy Cancer Registries from 2015-2019, we derived an unadjusted ASIR for cervical cancer of 4.16 per 100,000 women (95% UI 3.28, 5.28). Varying model assumptions produced adjusted ASIRs ranging from 5.2 to 8.4 per 100,000 women. We derived an adjusted ASIR of 7.60, (95% UI 5.98, 10.01) and estimated 6166 (95% UI 4833, 8305) new cases of cervical cancer per year.
Conclusion: The estimated cervical cancer burden in Pakistan is higher than the WHO target. Estimates are sensitive to health seeking behavior, and appropriate physician diagnostic intervention, factors that are relevant to the case of cervical cancer, a stigmatized disease in a low-lower middle income country setting. These estimates make the case for approaching cervical cancer elimination through a multi-pronged strategy.

Comments

Pagination are not provided by the author/publisher.

Publication (Name of Journal)

BMC Public Health

Recommended Citation

Chughtai, N. G., Perveen, K., Gillani, S. R., Abbas, A., Anwar, A., Karani, S., Noorali, A. A., Zakaria, M., Shamsi, U., Chishti, U., Soofi, S., Pervez, S., Samad, Z. (2023). National cervical cancer burden estimation through systematic review and analysis of publicly available data in Pakistan. BMC Public Health, 23(834).
Available at: https://ecommons.aku.edu/pakistan_fhs_mc_women_childhealth_obstet_gynaecol/254