Changing Trends in Incidence of Ovarian Cancer - the Indian Scenario

Ovarian cancer has emerged as one of the most common malignancies affecting women in India. The presentcommunication reports the trends in the incidence rate of ovarian cancer for Indian women. The data publishedin Cancer Incidence in Five Continents for various Indian registries for different periods and / or publication bythe individual registries served as the source material. Mean annual percentage change (MAPC) in rates wascomputed using relative differences between two time periods. During the period 2001-06, the age-standardizedincidence rates (ASR) for ovarian cancer varied from 0.9 to 8.4 per 100,000 person years amongst variousregistries. The highest incidence was noted in Pune &Delhi registries. The Age Specific Incidence Rate (ASIR)for ovarian cancer revealed that the disease increases from 35 years of age and reaches a peak between the ages55-64. The trend analysis by period showed an increasing trend in the incidence rate of ovarian cancer in mostof the registries, with a mean annual percentage increase in ASR ranged from 0.7% to 2.4 %. Analysis of databy ASIR revealed that the mean annual percentage increase was higher for women in the middle and older agegroups in most of the registries. Estimation of annual percent change (EAPC) in ovarian cancer by Poissonregression model through Maximum Likelihood Estimation (MLE) for the data of 3 population-based cancerregistries vs. Mumbai, Chennai and Bangalore for the period 1983-2002 revealed that linear regression wasfound to be satisfactory fit between period and incidence rate. Statistically significant increase in EAPC wasnoted with the crude rate (CR,) ASR, and ASIR for several age-groups. Efforts should be made to detect ovariancancer at an early stage by educating population about the risk factors. Most of the ovarian cancers areenvironmental in origin and consequently, at least in principle avoidable.     

Estimation of Time Trends of Incidence of Prostate Cancer – an Indian Scenario

Background: With increase in life expectancy, adoption of newer lifestyles and screening using prostatespecific antigen (PSA), the incidence of prostate cancer is on rise. Globally prostate cancer is the second mostfrequently diagnosed cancer and sixth leading cause of cancer death in men. The present communication makesan attempt to analyze the time trends in incidence for different age groups of the Indian population reportedin different Indian registries using relative difference and regression approaches. Materials and Methods: Thedata published in Cancer Incidence in Five Continents for various Indian registries for different periods and/orpublications by the individual registries served as the source materials. Trends were estimated by computing themean annual percentage change (MAPC) in the incidence rates using the relative difference between two timeperiods (latest and oldest) and also by estimation of annual percentage change (EAPC) by the Poisson regressionmodel. Results: Age adjusted incidence rates (AAR) of prostate cancer for the period 2005-2008 ranged from 0.8(Manipur state excluding Imphal west) to 10.9 (Delhi) per 105 person-years. Age specific incidence rates (ASIR)increased in all PBCRs especially after 55 years showing a peak incidence at +65 years clearly indicating thatprostate cancer is a cancer of the elderly. MAPC in crude incidence rate(CR) ranged from 0.14 (Ahmedabad)to 8.6 (Chennai) . Chennai also recorded the highest MAPC of 5.66 in ASIR in the age group of 65+. Estimatedannual percentage change (EAPC) in the AAR ranged from 0.8 to 5.8 among the three registries. Increase intrend was seen in the 5-64 year age group cohort in many registries and in the 35-44 age group in Metropolitancities such as Delhi and Mumbai. Conclusions: Several Indian registries have revealed an increasing trend inthe incidence of prostate cancer and the mean annual percentage change has ranged from 0.14-8.6.     

云南省肿瘤登记地区2011—2015年宫颈癌发病和死亡特征及时间趋势

目的 了解云南省肿瘤登记地区2011—2015年宫颈癌的发病和死亡特征及时间趋势,为开展宫颈癌防治提供参考.方法 收集整理2011—2015年云南省肿瘤登记地区宫颈癌(ICD-10编码为C53)的发病死亡病例.分城乡统计宫颈癌的发病率、死亡率、标化发病率、标化死亡率、截缩率、累积率(0～74岁)、趋势变化年度百分比(A...     

Evaluation of data quality at the Gambia national cancer registry

The Gambia National Cancer Registry (GNCR) is one of the few nationwide population‐based cancer registries in sub‐Saharan Africa. Most registries in sub‐Saharan Africa are limited to cities; therefore, the GNCR is important in providing estimates of cancer incidence in rural Africa. Our study assesses the quality of its data. The methods proposed by Bray and Parkin, and Parkin and Bray (Eur J Cancer 2009;45:747–64) were applied to the registry data from 1990 to 2009 to assess comparability, validity and completeness. The system used for classification and coding of neoplasms followed international standards. The percentage of cases morphologically verified was 18.1% for men and 33.1% for women, and that of death certificate only cases was 6.6 and 3.6%, respectively. Incidence rates in rural regions were lower than in the urban part of the country, except amongst young male adults. Comparison with other West African registries showed that the incidences of liver and uterine cervical cancer were comparable, but those of prostate and breast in The Gambia were relatively low. The overall completeness was estimated at 50.3% using the capture–recapture method. The GNCR applies international standard practices to data collection and handling, providing valuable data on cancer incidence in sub‐Saharan Africa. However, the data are incomplete in the rural and elderly populations probably because of health care access and use.     

Breast cancer incidence trends in European women aged 20–39?years at diagnosis

An increase in the incidence of breast cancer in women aged<40 years has been reported in recent years. Increased incidence could be partly explained by subtle detection biases, but the role of other risk factors cannot be ruled out. The purpose of the present study was to investigate the changes in temporal trends in breast cancer incidence in European women aged 20-39 years at diagnosis. Age specific breast cancer incidence rates for 17 European Cancer Registries were retrieved for the calendar period 1995-2006. Cancer registries data were pooled to reduce annual fluctuations present in single registries and increase incidence rates stability. Regression models were fitted to the data assuming that the number of cancer cases followed the Poisson distribution. Mean annual changes in the incidence rate (AIC) across the considered time window were calculated. The AIC estimated from all European registries was 1.032 (95% CI=1.019-1.045) and 1.014 (95% CI=1.010-1.018) in women aged 20-29 and 30-39 years old at diagnosis, respectively. The major change was detected among women aged 25-29 years at diagnosis: AIC=1.033 (95% CI=1.020-1.046). The upward trend was not affected when registries with high or low AIC were removed from the analysis (sensitivity analysis). Our findings support the presence of an increase in the incidence of breast cancer in European women in their 20s and 30s during the decade 1995-2006. The interpretation of the observed increase is not straightforward since a number of factors may have affected our results. The estimated annual increase in breast cancer incidence may result in a burden of the disease that is important in terms of public health and deserves further investigation of possible risk factors.     

Cervical cancer burden in Latin America and the Caribbean: Where are we?

In May 2018, the World Health Organization (WHO) called for the elimination of cervical cancer. To monitor this initiative, we examined cervical cancer incidence and mortality in the Latin America and Caribbean (LAC) region using GLOBOCAN 2018, Cancer Incidence in Five Continents Series, and the WHO Mortality Database. We estimated the number of cases and age-standardized rates (ASRs) for cervical cancer incidence and mortality for 2018. We also presented the ASRs for recorded cervical cancer incidence from the period 2008 to 2012. We calculated annual rates and analyzed trends in cervical cancer incidence and mortality for all ages combined and for the following age groups: 0–29, 30–49, 50–64 and 65+. Finally, we calculated the estimated average annual percentage change in incidence and mortality rates for the past 10 years. In 2018, an estimated 56,000 new cervical cancer cases and 28,000 cervical cancer deaths occurred among women in LAC with great variations between subregions and countries/territories. Overall, trends in cervical cancer incidence and mortality have decreased over the past decade; however, the rates are still above the elimination threshold of 4 per 100,000 in most LAC countries/territories. Despite the encouraging trends observed, achieving the elimination of cervical cancer in the region still requests substantial political commitment and economic effort. Population-based cancer registries are critical in monitoring the elimination initiative.     

Current status of gynecological cancer care in India

Cancer has become an important public health problem with over 800,000 new cases occurring every year in India. It is estimated that there are nearly 2.5 million cases in the country with nearly 400,000 deaths occurring due to cancer. Cancers of the female reproductive tract and breast has a high incidence amongst Indian women. Cancer registries have also highlighted that more than 70% of cancers in females occur in the age group of 35-64, and that these cancers exercise an adverse influence on the productive role of women in our society. Over 70% of patients report for diagnostic and treatment services at an advanced stage of disease, resulting in poor survival and high mortality rates. More than 50% were compliant to treatment protocol, less than 30% default during adjuvant therapy and 20% default after the preliminary investigation. Overall, 30% complete follow up in the regional institutes and 70-80% in private comprehensive care centers for five years.     

Trends in rectal cancer incidence--Indian scenario

The objective was to analyse time trends of rectal cancer for the Indian population by gender, year of diagnosis, and age. Published data for Indian registries were obtained from "Cancer Incidence in Five Continents" and /or individual Indian registries for different time periods. Mean annual percentage change (MAPC) in incidence rates for seven Indian registries was computed using relative difference between two time periods (earliest and latest) and estimation of annual percentage change (EAPC) was computed for three registries by log-linear regression model using SAS version 8.1. The age standardized incidence rate (ASR) of rectal cancer during 2004-2006 ranged from 0.0 to 5.0 per 100,000 population with a male preponderance in most Indian registries. Among males, excepting for the Southern cities, all other registries revealed a decreasing trend/no change in the MAPC both in crude incidence rate (CR) and ASR. However, in females, an increase in MAPC in CR was noted in several registries. Statistically significant increase in EAPC in CR was observed in all the three registries ranging from 1.45% to 3.99% in males while in females the increase was 1.13% in Mumbai and 1.76% in Bangalore. Further studies are required to understand these changing trends and factors that operate in the aetiology of rectal cancer in the Indian scenario. Higher incidence in males indicates the need for greater attention to understand the causes of gender disparities.     

Incidence of cancer in Nairobi,Kenya (2004–2008)

Cancer incidence rates are presented for the Nairobi Cancer Registry, a population‐based cancer registry (PBCR) covering the population of the capital city of Kenya (3.2 million inhabitants in 2009). Case finding was by active methods, with standard and checks for accuracy and validity. During the period 2004–2008 a total of 8,982 cases were registered comprising 3,889 men (an age standardized incidence rate (ASR) of 161 per 100,000) and 5,093 women (ASR 231 per 1,00,000). Prostate cancer was the most common cancer in men (ASR 40.6 per 100,000) while breast cancer was the most common among women (ASR 51.7 per 100,000). Cervical cancer ranked the second most common cancer among women in Nairobi with an ASR of 46.1 per 100,000, somewhat lower than those of other registries in East Africa region. Breast and cervical cancers accounted for 44% of all cancers in women. Cancer of the oesophagus was common in both sexes, with a slight excess of cases in men (sex ratio 1.3). Unlike other regions in East Africa, the rate of Kaposi sarcoma was relatively low during the period (men 3.6/100,000; women 2.0/100,000). Although incidence rates cannot be calculated for the early years of the registry, the increase in relative frequency of prostate cancer and declines in frequency of Kaposi sarcoma may indicate underlying trends in the risk of these cancers.     

The burden of cervical cancer in China: synthesis of the evidence

The burden of cervical cancer in China has not been characterized in detail. We reviewed cervical cancer data from national mortality surveys and registries, and conducted a meta-analysis to estimate the prevalence of high-grade lesions (HSIL) and high-risk human papillomavirus (HR-HPV) infections in rural Shanxi Province. We found that a national survey in the 1970s estimated age-standardized cervical cancer mortality rates as ~15 and ~83/100,000 women nationally and in Xiangyuan, Shanxi; but the latest survey (2004-2005) found much lower rates of ~3 and ~7/100,000, respectively. IARC registries record age-standardized cervical cancer incidence in China as <5/100,000 (1998-2002); but the five registry sites cover <2% of the population, and the gross domestic product per capita at each of the registry sites is higher than China's average (by a factor ranging from 1.3 to 3.9). The pooled estimate of the prevalence of HSIL and HR-HPV in women aged 30-54 years in Shanxi was 3.7%(95%CI:2.7-4.8%) and 17.2%(95%CI:13.1-21.3%), respectively. Based on a feasible range informed by the incidence data for China and other unscreened populations, the predicted indicative annual number of new cervical cancer cases nationally, in the absence of any intervention, ranges from ~27,000 to 130,000 (2010) to 42,000 to 187,000 (2050). In conclusion, recent data suggest comparatively low rates of cervical cancer incidence in China, which may be partly explained by the location of registry sites in higher socioeconomic status areas. However, the evidence is consistent with considerable heterogeneity within China, with a higher disease burden in some rural areas such as Shanxi. Therefore, the lower reported rates of cervical cancer in China should be interpreted cautiously.     

Descriptive Epidemiology of Gastrointestinal Cancers: Results from National Cancer Registry Programme,India

Purpose: This study aims to determine the incidence, histology, clinical extent of disease, and trends of gastrointestinal (GI) cancers in India. Methods: GI cancer cases diagnosed between 2012-2016 from 28 Population-Based Cancer Registries and 58 Hospital Based Cancer Registries under the National Cancer Registry Programme were included. Crude incidence rate and age-standardized incidence rates (AARs) were calculated. Joinpoint regression program, 4.0.1 was used for trend analysis for data from 1982 to 2016, and a P-value of <<0.05 was considered statistically significant. Results: GI cancers’ occurrence was more common among men (60.5%) than in women (39.5%). The incidence of GI cancer was highest in India’s northeast region, Aizawl district (AAR 126.9) among males, and in Papumpare district (AAR 75.9) among females. The commonest cancer among men was cancer of the esophagus (28.2%), followed by stomach cancer (21%) and rectum cancer (14.3%). Among women, cancer of the esophagus (25.7%), gallbladder (23.8%), stomach (14.8%), and rectum (14.6%) were common. Adenocarcinoma (57.83%) was the commonest type of GI tumors, followed by Squamous Cell neoplasms (25.99%). Majority of the GI cancers presented at the locoregional stage, but cancer of the gall bladder and pancreas presented at advanced stages. A rising trend for cancers of the colon, rectum, liver, gall bladder, pancreas was seen, while a declining trend was observed for stomach and oesophageal cancer. Conclusion: Our study highlights an increasing magnitude of GI cancers across different regions of India. Cancer registries form an essential tool for surveillance of GI cancers thus guiding prevention, early detection, and control programs.     

Trends in the Incidence of 15 Common Cancers in Hong Kong, 1983-2008

Background: The objective of this study WAS to describe cancer incidence rates and trends among THE HongKong population for the period 1983-2008. Methods: Incident cases and population data from 1983 to 2008 wereobtained from the Hong Kong Cancer Registry and the Census and Statistics Department, respectively. Agestandardizedincidence rates (ASIR) were estimated and joinpoint regression was applied to detect significantchanges in cancer morbidity. Results: For all cancers combined, the ASIR showed declining trends (1.37%in men, 0.94% in women), this also being the case for cancers of lung, liver, nasopharynx, stomach, bladder,oesophagus for both genders and cervix cancer for women. With cancer of thyroid, prostate, male colorectal,corpus uteri, ovary and female breast cancer an increase was evident throughout the period. The incidence forleukemia showed a stable trend since early 1990s, following an earlier decrease. Conclusions: Although overallcancer incidence rates and certain cancers showed declining trends, incidence trends for colorectal, thyroid andsex-related cancers continue to rise. These trends in cancer morbidity can be used as an important resource toplan and develop effective programs aimed at the control and prevention of the spread of cancer amongst theHong Kong population. It is particularly useful in allowing projection of future burdens on the society with theincrease in certain cancer incidences.     

The Trend and Prediction of Cervical Cancer Incidence in Delhi,India: An Age-Period-Cohort Analysis

Objective: The objective of the study is to assess the trend of age-standardised incidence rate (ASIRs) of cervical cancer, standardised median age at diagnosis, and projection of cervical cancer incidence rate and the number of new cases up to 2030. The projections help in making strategies for resource allocation to circumvent the future burden. Methods: The data were extracted from the Delhi population-based cancer registry from 1990 to 2014. Joinpoint regression analysis was applied to ASIRs to assess the trend. The natural cubic splines age-period-cohort (APC) model was fitted to project the incidence rate and incidence cases. The trend of standardised median age at diagnosis and percentage of cervical cancer to total women cancer was also assessed using regression analysis. Projections of new cases are decomposed into three components aging, the structure of the population, and age-specific incidence rate. Results: The age-standardised incidence rate of cervical cancer decreased with an annual decline at a rate of 2.98% (95% CI -3.48 to -2.47) from 1990 to 2014. The standardised median age at diagnosis showed an upward trend with an average annual increase of 0.167 per year and the median age increased by 4.18 years during 25-years period, this change was due to the shifting of the peak from 40-44 in 1990 to 60-64 in 2014. The APC model revealed ASIRs would decline by 43.8% in 2030 compared to average ASIRs 2010-2014, albeit a net 12% increase in the incidence cases. An increase in incidence cases is primarily attributed to the aging of the population and population  growth by 38.87% and 33.84% respectively.  The trend analysis of  cervical cancer ASIRs in pre (< 50 years) and post menopause (≥ 50 years) showed a decreasing trend. However, the ratio of cervical to total women increased over time from 1:1 in 1990 to 2:3 in 2014. Conclusion: The declining trend in ASIRs was observed in Delhi and will continue to decrease up to 2030.  The burden of the number of new cases of cervical cancer showed an upward trend primarily due to the aging of the population and shifting of population structure. To counter this big challenge a cost-effective vaccination for vulnerable populations, community-based screening programs, and awareness about cervical cancer prevention might help in eliminating this preventable cancer.     

Decreasing rates of cervical cancer among American Indians and Hispanics in New Mexico (United States)

Minority women in New Mexico (United States)—including American Indian and Hispanic women—have shown disproportionately high incidence rates of invasive cervical cancer during the 1960s and 1970s. Several public health programs in New Mexico were directed toward early detection of cervical cellular abnormalities, particularly targeting the state's minority women. To evaluate the effectiveness of these programs, we examined the New Mexico Surveillance, Epidemiology, and End Results (SEER) data collected from 1969–92, and calculated average annual, age-specific, and age-adjusted incidence rates by ethnic group (American Indian, Hispanic, and non-Hispanic White) for five-year time intervals. We also calculated age-adjusted mortality rates for cervical cancer in the same ethnic groups using state vital records. Age-adjusted incidence rates for invasive cervical cancer show substantial temporal decreases, especially for minority women in the state. The age-adjusted incidence rate decreased by 66 percent, from 30.3 to 10.3 per 100,000 for American Indian women, and by 61 percent, from 26.1 to 10.2 per 100,000 for Hispanic women. A stage shift to earlier stages of cervical neoplasia occurred over the study period, with a substantially higher proportion of in situ compared with invasive cancers diagnosed in the most recent cf the most remote time period. The ratio of incidence rates of in situ to invasive cancers changed dramatically for both American Indian and Hispanic women. Cervical cancer mortality rates decreased steadily among Hispanic women from 1958 to 1992; the decrease among American Indian women was less stable and fluctuated due to small numbers. Ongoing targeted sceening programs should help to reduce cervical cancer incidence and mortality further in New Mexico.Drs Chao, Becker, Jordan, Darling, Gilliland, and Key are with the New Mexico Tumor Registry/Epidemiology and Cancer Control Program, Albuquerque, NM, USA. Dr Jordan and also Dr Key are with the Department of Pathology, University of New Mexico Health Sciences Center, Albuquerque, NM. Address correspondence to Dr Chao, New Mexico Tumor Registry, University of New Mexico Cancer Research and Treatment Center, 900 Camino de Salud NE, Albuquerque, NM, 87131-5306, USA.     

Projection of Cancer Incident Cases for India -Till 2026

Projection of cancer incidence is essential for planning cancer control actions, health care and allocationof resources. Here we project the cancer burden at the National and State level to understand the magnitudeof cancer problem for the various calendar years from 2011 to 2026 at 5-yearly intervals. The age, sex andsite-wise cancer incidence data along with populations covered by the registries were obtained from the reportof National Cancer Registry Programme published by Indian Council of Medical Research for the period2001-2004. Pooled age sex specific cancer incidence rates were obtained by taking weighted averages of theseseventeen registries with respective registry populations as weights. The pooled incidence rates were assumedto represent the country’s incidence rates. Populations of the country according to age and sex exposed to therisk of development of cancer in different calendar years were obtained from the report of Registrar Generalof India providing population projections for the country for the years from 2001 to 2026. Population forecastswere combined with the pooled incidence rates to estimate the projected number of cancer cases by age, sexand site of cancer at various 5-yearly periods Viz. 2011, 2016, 2021 and 2026. The projections were carried outfor the various leading sites as well as for ‘all sites’ of cancer. In India, in 2011, nearly 1,193,000 new cancercases were estimated; a higher load among females (603,500) than males (589,800) was noted. It is estimatedthat the total number of new cases in males will increased from 0.589 million in 2011 to 0.934 million by theyear 2026. In females the new cases of cancer increased from 0.603 to 0.935 million. Three top most occurringcancers namely those of tobacco related cancers in both sexes, breast and cervical cancers in women accountfor over 50 to 60 percent of all cancers. When adjustments for increasing tobacco habits and increasing trendsin many cancers are made, the estimates may further increase. The leading sites of cancers in males are lung,oesophagus, larynx, mouth, tongue and in females breast and cervix uteri. The main factors contributing to highburden of cancer over the years are increase in the population size as well as increase in proportion of elderlypopulation, urbanization, and globalization. The cancer incidence results show an urgent need for strengtheningand augmenting the existing diagnostic/tr eatment facilities, which are inadequate even to tackle the present load.     

Trends in Breast Cancer Incidence in Iraq During the Period 2000-2019

Background: Breast cancer is the most common cancer among women around the world. Objective: This study aims to explore the time trends in the incidence of breast cancer in Iraq in twenty years period (2000 to 2019) to assist health officials and decision-makers in planning and organizing programs to controlling breast cancer growth and enhance women’s health. Methods: Breast cancer data from 2000 to 2019 were obtained from the Iraqi Cancer Registry’s yearly book series (Ministry of Health). The United Nations Population Division provides annual population estimates by 5-year age groups and gender. Joinpoint regression analysis was used to calculate and assess age-specific and age-standardized incidence rates. Results: A total of 72,022 breast cancer cases were identified among women in Iraq between 2000 and 2019. The average age-standardized incidence rate (ASIRs) was 37.883/100,000. Breast cancer ASIR Iraq exhibited a significantly rising trend during the study period, with an average annual percentage change (AAPC) of +3.192%. Furthermore, a significant increase in breast cancer incidence for the age group 40–49 (AAPC = +2.162%), 50–59 (AAPC=+3.210%), 60–69 (AAPC=+5.551%), and age 70 and over (AAPC=+7.943%) were observed. When compared to other countries in the world, Iraq had a moderate rate of breast cancer ASIR. Conclusions: In summary, our finding revealed an increase in the incidence rates of breast cancer among Iraqi women from 2000 to 2019. Further research is needed to explore risk factors including levels of overweight, dietary changes, physical inactivity, obesity, smoking, high marriage age, and low birth rates to prevent and control breast cancer.     

Cervical cancer incidence among 6 Asian ethnic groups in the United States, 1996 through 2004

BACKGROUND:

Cervical cancer incidence was evaluated by histologic type, age at diagnosis, and disease stage for 6 Asian ethnic groups residing in the United States.

METHODS:

Incidence rates were estimated for cervical squamous cell carcinoma (SCC) and adenocarcinoma by age and stage for 6 Asian ethnic groups—Asian Indian/Pakistani, Chinese, Filipino, Japanese, Korean, and Vietnamese—in 5 US cancer registry areas during 1996 through 2004. For comparison, rates among non‐Hispanic whites, non‐Hispanic blacks, and Hispanics were also calculated.

RESULTS:

During 1996 through 2004, Vietnamese women had the highest (18.9 per 100,000) and Asian Indian/Pakistani women had the lowest (4.5) incidence of cervical cancer; this pattern was consistent by histologic type. Vietnamese women also had the highest incidence for localized (7.3) and regional (5.7) SCC and for localized (2.4) adenocarcinoma. Contrary to the plateau of SCC incidence apparent among white women by age 45 years, SCC rates continued to rise with age among Chinese, Filipina, Korean, and Vietnamese women.

CONCLUSIONS:

There exists large variation in invasive cervical cancer incidence patterns among Asian ethnic groups in the United States and in comparison with rates for blacks, Hispanics, and whites. Early detection and prevention strategies for cervical cancer among Asians require targeted strategies by ethnic group. Cancer 2010. Published 2010 by the American Cancer Society.     

Cervical Cancer in Khon Kaen,Thailand: Analysis of 1990-2014 Incidence Data and Prediction of Future Trends

Background: Cervical cancer is the second most common cancer of women in Thailand. There have been no reportsof incidence and future in Khon Kaen, a province in northeastern Thailand, where the relatively high prevalence givesevaluation of cervical cancer screening a high priority. Objectives: To determine cervical cancer incidence rates inKhon Kaen for 1990–2014 and predict future trends until 2029. Methods: Cancer incidence data from the Khon Kaenpopulation-based cancer registry were analyzed and age-standardized incidence rates (ASR) were estimated. Joinpointanalysis and age-period-cohort modeling were applied for data from 1990 to 2014 and the Nordpred package wasemployed to project trends from 2015 to 2029. Results: Between 1990 and 2014, a total of 3,258 cases were diagnosedwith ICD-O code C53 (invasive cervical cancer). Before 2005, an annual percentage change (APC) varied widely, withoutliers in 1993 and 1999. The APC computed with the Joinpoint software decreased at -2.8% (95% CI;-4.5 to -1.1)per year on average. After 2005, a rise was noted until 2008, after which a drop became apparent with an APC of-8.0% (95% CI; -14.5 to -1.1) per year on average. Both period and cohort effects played a role in shaping the decreasein incidence. The three projection method suggested that incidence rates would continue to decrease in the future.Conclusions: A decreasing trend in incidence of cervical cancer in Khon Kaen was noted from 1990 to 2014 with aprediction of continuous decrease until 2029. Maintenance and improvement of the screening program is advised.