A POPULATION-BASED APPROACH TO CERVICAL CANCER: THE CONTEMPORARY IMPORTANCE OF CANCER REGISTRIES, SCREENING, AND SURVIVAL ANALYSIS
Keywords:
cervical cancer; population-based approach; cancer registry; screening; HPV; survivalAbstract
This narrative review highlights the contemporary importance of a population-based approach to cervical cancer (CC). We summarize global and regional epidemiologic patterns of CC, the etiologic role of high-risk human papillomavirus (HPV), major risk factors, and the prevention framework built on HPV vaccination, organized screening, and early diagnosis. Cancer registries are discussed as the core information infrastructure for cancer control, including their definition, main types, and their value for surveillance, planning, and evaluation. The role of international standards and registry networks (IARC/IACR, ENCR, SEER, NPCR) and global initiatives such as Cancer Incidence in Five Continents (CI5) is outlined with regard to data comparability, quality assurance, and cross-country benchmarking. We also address the organization of oncology services in Uzbekistan and the limitations of aggregated official reporting for robust outcome assessment. Strengthening the population-based cancer registry, implementing systematic data quality control, ensuring continuous follow-up, and integrating registry data with mortality and screening databases are emphasized as prerequisites for valid population survival estimates. Key survival metrics (overall, relative, and net survival), common analytical approaches, and interpretation issues are briefly reviewed. Evidence from EUROCARE and CONCORD demonstrates that international differences in CC survival largely reflect screening coverage and the completeness and quality of registry data.
References
Bray F., Ferlay J., Soerjomataram I., Siegel R.L., Torre L.A., Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: A Cancer Journal for Clinicians. 2018;68(6):394–424. (in Uzb)
Doll R., Payne P., Waterhouse J. (eds.) Cancer Incidence in Five Continents. Vol. I. Geneva: UICC; 1966. (in Uzb)
Ministry of Health of the Republic of Uzbekistan. State statistical reports on oncological diseases in the Republic (annual compilations). Tashkent: State Committee on Statistics of the Republic of Uzbekistan; (by years). (in Uzb)
Merabishvili V.M. Survival of Cancer Patients. Saint Petersburg: Publishing and Printing Company “KOSTA”; 2006. 440 p. (in Uzb)
Мерабишвили В.М. Выживаемость онкологических больных. СПб: Издательская полиграфическая компания «КОСТА»; 2006. 440 с. (in Uzb)
De Angelis R., Sant M., Coleman M.P., Francisci S., Baili P., Pierannunzio D., et al. Cancer survival in Europe 1999–2007 by country and age: results of EUROCARE-5—a population-based study. European Journal of Cancer. 2014;50:1510–1522. (in Uzb)
Bosch F.X., Lorincz A., Muñoz N., Meijer C.J.L.M., Shah K.V. The causal relation between human papillomavirus and cervical cancer. Journal of Clinical Pathology. 2002;55(4):244–265. (in Uzb)
Muñoz N., Bosch F.X., de Sanjosé S., Herrero R., Castellsagué X., Shah K.V., et al. Epidemiologic classification of human papillomavirus types associated with cervical cancer. The New England Journal of Medicine. 2003;348(6):518–527. (in Uzb)
Schiffman M., Castle P.E., Jeronimo J., Rodriguez A.C., Wacholder S. Human papillomavirus and cervical cancer. The Lancet. 2007;370(9590):890–907. (in Uzb)
World Health Organization. Global strategy to accelerate the elimination of cervical cancer as a public health problem. Geneva: WHO; 2020. 56 p. (in Uzb)
Landy R., Sasieni P., Cuzick J., et al. Impact of cervical screening on cervical cancer mortality: estimates using epidemiologic data from England. Journal of Epidemiology & Community Health. 2016;70(8):780–786. (in Uzb)
Estève J., Benhamou E., Croasdale M., Raymond L. Relative survival and the estimation of net survival: elements for further discussion. Statistics in Medicine. 1990;9(5):529–538. (in Uzb)
Parkin D.M. The evolution of the population-based cancer registry. Nature Reviews Cancer. 2006;6(8):603–612. (in Uzb)
Hutchison C.L., Menck H.R., Burch J.D., Gottschalk R. A systematic review of hospital cancer registries. Journal of Registry Management. 2010;37(4):166–175. (in Uzb)
Bray F., Parkin D.M. Evaluation of data quality in the cancer registry. Part I: comparability, validity and timeliness. European Journal of Cancer. 2009;45(5):747–755. (in Uzb)
Pohar Perme M., Stare J., Estève J. On estimation in relative survival. Biometrics. 2012;68(1):113–120. (in Uzb)
Howlader N., Noone A.M., Krapcho M., Miller D., Brest A., Yu M., et al. (eds.) SEER Cancer Statistics Review, 1975–2018. Bethesda: National Cancer Institute; 2021. (in Uzb)
European Network of Cancer Registries (ENCR). ENCR recommendations on coding and registration. Lyon: IARC; 2015. (in Uzb)
Thoburn K.K., German R.R., Lewis M., Nichols P.J., Ahmed F., Jackson-Thompson J. Case completeness and data accuracy in the CDC National Program of Cancer Registries. Cancer. 2007;109(8):1607–1616. (in Uzb)
Sankaranarayanan R., Swaminathan R., Brenner H., Chen K., Chia K.S., Chen J.G., et al. Cancer survival in Africa, Asia, and Central America. The Lancet Oncology. 2010;11(2):165–173. (in Uzb)
Jensen O.M., Parkin D.M., MacLennan R., Muir C.S., Skeet R.G. (eds.) Cancer registration: principles and methods. IARC Scientific Publications. 1991;(95):1–296. (in Uzb)
Bray F., Colombet M., Mery L., et al. Cancer Incidence in Five Continents, Vol. XI. IARC Scientific Publications. Lyon: IARC; 2015. 1445 p. (in Uzb)
Pollack L.A., et al. National Program of Cancer Registries electronic pathology reporting (standards/business rules; NAACCR Volume V referenced). [PMC article] 2020. (in Uzb)
Bray F., Parkin D.M. Evaluation of data quality in the cancer registry. Part II: completeness. European Journal of Cancer. 2009;45(5):756–764. (in Uzb)
Tillashaykhov M.H., Dzhanklich S.M., Imamov O.A. Implementation of a National Cancer Registry System and Issues of Digitalization of Oncological Data. Tashkent; 2025. (in Uzb)
Мерабишвили В.М. Онкологическая статистика (традиционные методы, новые информационные технологии). Руководство для врачей. Часть I. СПб: КОСТА; 2015. 223 с. (in Uzb)
Barchuk A., Belyaev A., Gretsova O., et al. History and current status of cancer registration in Russia. Cancer Epidemiology. 2021;73:101963. (in Uzb)
Allemani C., Weir H.K., Carreira H., Harewood R., Spika D., Wang X.S., et al. Global surveillance of cancer survival 1995–2009: analysis of individual data for 25 676 887 patients from 279 population-based registries. The Lancet. 2015;385(9972):977–1010. (in Uzb)
Dickman P.W., Hakulinen T. Survival analysis. Tallinn: Institute of Experimental and Clinical Medicine; 2000. 248 p. (in Uzb)
Estève J., Benhamou E., Croasdale M., Raymond L. Relative survival and the estimation of net survival. Statistics in Medicine. 1990;9(5):529–538. (in Uzb)
De Angelis R., et al. Cancer survival in Europe 1999–2007 by country and age: the EUROCARE-5 study. European Journal of Cancer. 2014;50:1510–1522. (in Uzb)
De Angelis R., Sant M., Coleman M.P., et al. EUROCARE-5 (final conclusions). European Journal of Cancer. 2014;50:1510–1522. (in Uzb)
Vaccarella S., Lortet-Tieulent J., Plummer M., Franceschi S., Bray F. Worldwide trends in cervical cancer incidence: impact of screening against changes in disease risk factors. European Journal of Cancer. 2013;49(15):3262–3273. (in Uzb)
World Health Organization. Global strategy to accelerate the elimination of cervical cancer as a public health problem. Geneva: WHO; 2020. 56 p. (in Uzb)
