Time Trends for Incidence and Net Survival of Cervical Cancer in Sweden 1960-2014-A Nationwide Population-Based Study

Background: The aim was to investigate time trends for incidence and long-term net survival in the morphologic subtypes and stages of cervical cancer in Sweden during the period 1960 to 2014. Methods: Women with invasive cervical cancer were identified through the Swedish Cancer Registry. Incidence and net survival were calculated according to morphology, age at diagnosis, and FIGO stage at diagnosis. Results: In total, 29,579 cases of invasive cervical cancer between 1960 and 2014 were included. The age-standardized incidence for squamous cell carcinoma (SCC) decreased until 2000; thereafter, the incidence rate stagnated, and a small increase was found in 2014. The incidence of adenocarcinoma continuously increased. The age-standardized 5-year net survival increased. However, decreasing net survival with increasing age was found. A higher stage at diagnosis showed a worse net survival. SCC and adenocarcinoma did not statistically differ as regards net survival in the last years of the study. Conclusions: Age-standardized 5-year net survival improved between 1960 and 2014. A positive trend for short-and long-term net survival was seen for women ages 18 to 64 years but long-term net survival for women >= 75 years decreased. In this study, age and FIGO stage at diagnosis were found to be important prognostic factors in determining net survival. The morphologies, SCC, and adenocarcinoma did not statistically differ as regards net survival in the last years of the study. Impact: This study demonstrates longitudinal data on cervical cancer in Sweden for over 50 years with sub analyses on morphology, age, and stage at diagnosis.

Automated summary

This study investigates the time trends of cervical cancer incidence and net survival in Sweden from 1960 to 2014. The results show that the incidence of squamous cell carcinoma (SCC) decreased until 2000 and then remained stagnant, while adenocarcinoma continued to increase. The 5-year net survival improved overall, but decreased with increasing age and higher stage at diagnosis. There was no statistically significant difference in net survival between SCC and adenocarcinoma in recent years.