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.