The incidence of cancer of the uterine cervix in Jamaica - abstract

ABSTRACT

This communication presents data on the occurrence of uterine cervical cancer as it has been observed in a standard urban population in Jamaica for a 13-year period (1958-1970). The case card of each patient entered in the files of the Jamaica Cancer Registry has been examined personally. During the 13-year period under study, a total of 2,607 cases of cervical diagnosis was obtained in 88 percent. The peak age at occurrence was 50-54 years. Of the total number, 1,170 cases were permanently resident in the parishes of Kingston and St. Andrew where few or no cancer cases go undetected and cancer registration is fairly complete. Only these were therefore used for calculation of accurate incidences using an estimated yearly population for the period 1958-1970 based on the 1960 census. The mean annual incidence for the whole period was 33.2 per 100,000. When this rate was adjusted to a standart population thereby enabling meaningful comparisons with other areas, the Jamaican incidence was found to be the third highest in the world next to Cali, Colombia, and the Southern Rhodesian African in Bulawayo. Comparisons on an age-specific basis revealed similar patterns between Jamaica and the South African Bantu with the highest incidence in the 7th decade whereas in European populations the peak age was in middle life with a gradual decline after the menopause. The peak age incidence obtained in this study for Jamaica discards earlier impressions (Pinkerton, 1956) that in this country the condition occurs 10-15 years earlier than in the United States and Britain. Analysis of the annual trend in cervical cancer incidence showed higher rates for the first few years due perhaps to an accumulation of cases diagnosed before the Jamaican Cancer Registry was established. Another trend observed was a relative rise in incidence during the period 1967-1969 which coincided with an increase in the number of cases of carcinoma in situ diagnosed following the introduction of routine cytology in 1966. Cervical cancer comprised 16 percent of all cancers in Jamaica (males and females). It is the commonest female malignancy accounting for 27 of all cases. Cervix and breast cancer together make up about half of all female cancers and interestingly, they both show an almost identical age-specific pattern (AU)