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Abstracto

Age and Ethnic Differences in the Occurrence of Cervical Dysplasia, Cervical Cancer, and Cervical Cancer Deaths in Suriname

Irving ER and Mans DRA

Background: Updated information on the frequency of premalignant cervical lesions in Suriname is scant, while currently available data on the age and ethnic distribution of cervical dysplasia, cervical carcinoma, and cervical cancer deaths are inconsistent and conflicting. For these reasons, we assessed these topics using a retrospective cohort approach.

Methods and Findings: Using secondary data, the incidence of cervical dysplasia (1995 - 2006) and cervical cancer (1980 - 2008), as well as cervical cancer mortality (1995 - 2010) was estimated and stratified per 10-year age groups and ethnic background. Data were evaluated for statistically significant differences using the Chi-square test and ANOVA, and expressed per 100,000 females per year. There were 2,554 records of dysplasia, 1, 117 for cervical carcinoma, and 283 for cervical cancer deaths during the indicated periods. The distribution of cervical dysplasia followed international patterns with a frequency of 1.7%for all lesions and for CIN1, CIN2 and CIN3/CIS of0.9, 0.5 and 0.3%, respectively. The average cervical cancer incidence was 24 per 100,000 women per year, and the average mortality rate was 10 per 100,000 women per year. The high-risk age groups for overall cervical dysplasia, cervical cancer, and mortality due to this disease were 30-49 (64-71%), 30-59 (60%), and 60-79 years (40%), respectively. Excess risk for cervical cancer and cervical cancer death was seen in Indigenous and Creole women. When compared to the other ethnic groups, Maroon women had the lowest cervical cancer incidence and mortality rates.

Conclusions: Despite incomplete cancer registries, our data suggest that Suriname represents a high- risk country for cervical cancer; that current screening practices have a very limited impact on the incidence and mortality; and that high-risk groups are women aged 30-49 years and those of Indigenous and Creole background. These findings support the implementation of more targeted screening programs.