Epidemiology of Cervical Cancer in Brazil: Age-Specific Trends From 2000 to 2018

Cervical cancer (CC) remains a significant public health challenge in low- and middle-income countries (LMICs), including Brazil. While global incidence has declined, age-specific variations may mask emerging trends among younger women. This study aimed to evaluate trends and age-specific changes in CC incidence in Brazil between 2000 and 2018.

Incidence data and age at diagnosis were obtained from Brazilian Population-Based Cancer Registries (PBCRs) for the period 2000-2018. Temporal trends were evaluated using Joinpoint regression to estimate annual percent changes (APCs) and average APCs (AAPCs).

Between 2000 and 2018, 66,358 CC cases were identified across 33 PBCRs. The median age at diagnosis was 51 years (IQR, 40-63), declining from 52 years in 2000 to 48 years in 2018. The overall adjusted incidence showed a significant decline between 2000 and 2013 (APC: -4.5% [95% CI, -5.3 to -3.7]; P < .001) followed by a nonsignificant increase from 2013 to 2018 (APC: 3.1 [95% CI, -1.6 to 8.1]; P = .20). Age-stratified analyses revealed rising trends among women age 25-44 years, suggesting a transition to younger age at diagnosis.

The observed decrease in median age and rising incidence among women younger than 45 years indicate a potential epidemiologic shift in CC in Brazil. These findings highlight the need to strengthen national screening programs, expand human papillomavirus (HPV) vaccination coverage, and incorporate molecular HPV testing into prevention strategies.