Cancer of the cervix uteri (ICD-9 180)

This category includes microinvasive carcinomas, but excludes carcinoma in situ lesions.

The incidence rate was highest in the former GDR (226/10⁶) and lowest in Finland (42/10⁶). Excluding these two extremes, the variation was considerably smaller, from 87/10⁶ in Sweden to 170/10⁶ in Poland. Mortality rates varied from 20/10⁶ in Finland to 79/10 ⁶ in Poland. There was only little variation within countries.

After the age of about 40, the age-specific incidence rate was rather stable in all countries except Finland where the incidence first was much lower and slowly reached the level of other countries around the age of 70. In mortality, there was a more stable increase with age in all countries, and also the mortality rates in younger age groups were considerably lower in Finland than in the other countries.

Comparison of the area specific mortality/incidence ratios in this case are misleading because screening radically changes the stage distribution of the cases.

A large number of sexual partners increases the risk of cervical cancer, mainly due to transmission of Human papillomavirus types 16 and 18. Mass screening of precancerous lesions of the cervix is a powerful tool in decreasing the occurrence of cervical cancer. In Finland, the population-based organised screening begun in the mid-1960s, and after that the incidence and mortality in the screened age groups (30 to 54) has declined by some 80%. In the former GDR, Iceland and Denmark there are also screening programmes but their effects on the age patterns of cervical cancer are less obviously visible than in Finland. The high incidence rate in the former GDR attributable to ages 20-40 possibly indicates that this rate includes cases which in other countries are not classified as invasive cancers.

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