A COMPARATIVE ANALYSIS OF TRENDS IN CERVICAL CANCER MORTALITY AMONG MESTIZO AND INDIGENOUS WOMEN IN ECUADOR,...

Cervical cancer is one of the leading causes of death from malignant neoplasms among women in Ecuador, a problem influenced by social and health determinants. The objective of this study is to analyze the trends and magnitude of inequalities in cervical cancer mortality among mestizo and indigenous women in Ecuador during the period 2010-2024. The study design is observational, retrospective, and ecological, using a time-series approach. A total of 6,090 deaths of women aged 20 years and older recorded by the National Institute of Statistics and Census (ICD-10 code: C53) were included. Age-standardized mortality rates were calculated. Joinpoint regression models were used to assess trends. Risk gaps were quantified using the mortality rate ratio (MRR) by comparing the three-year periods 2010-2012 and 2022-2024. Mestizo women accounted for 87.8% of deaths, and indigenous women for 6%. The trend among the mestizo population remained stable (APC: 0.8%), while the indigenous population increased (APC: 3.3%). A statistically significant increase was observed in the indigenous cohort aged 20 to 44 (APC 11.2%). In the 2010-2012 period, indigenous women aged ≥65 had lower mortality than mestizo women (MRR 0.64); however, in 2022-2024, a numerical trend toward risk reversal was observed (MRR 1.13; 95% CI: 0.82-1.55), without reaching statistical significance. Cervical cancer mortality in Ecuador follows divergent trajectories depending on ethnicity. The increase among young indigenous women and the shift in risk among older women highlight profound structural inequities in access to prevention.