Cervical Cancer Mortality Trends and Avoided Deaths in 48 Countries With Longitudinal Surveillance Data From GLOBOCAN, 1950-2018

PURPOSE Cervical cancer (CC) is a major cause of cancer-related morbidity and mortality in women globally. Over the past decades, advances in CC control, including screening, early detection, and treatment, have contributed to mortality reductions. Quantifying this long-term progress is important for understanding historical improvements in disease control. We examined long-term trends in avoided mortality across 48 countries with sufficient longitudinal surveillance data to describe historical progress in CC control. METHODS We used age-specific population counts and CC mortality rates for 1950-2018 from the WHO's Global Cancer Observatory. Age-standardized mortality rates (ASMRs), standardized to the WHO (2000-2025) Standard Population, were estimated. Peak mortality for each country was defined as the maximum ASMR (based on a 5-year rolling average). Expected deaths after peak year were calculated by applying peak-year age-specific mortality rates to subsequent population counts. Avoided deaths were defined as the difference between expected and observed deaths. Standardized mortality ratios (SMRs) were estimated as the ratio of observed to expected deaths with 95% CIs. RESULTS Across 48 countries, an estimated 1.3 million CC deaths were avoided. Eight (17%) of 48 countries experienced a high reduction in CC mortality (SMR < 0.50), with highest reductions in Iceland (SMR 0.28, 0.24-0.32), Canada (SMR 0.35, 0.34-0.35), and Finland (SMR 0.38, 0.37-0.39). Twenty-four (50%) countries had moderate reductions (SMR 0.50-0.75), whereas 16 (33%) had low reductions (SMR > 0.73). CONCLUSION Although not globally representative, substantial CC mortality reductions occurred in many countries with available long-term mortality data, reflecting historical progress in CC control. However, reductions varied by country, and most occurred before widespread human papillomavirus vaccination. These findings highlight the ongoing importance of comprehensive CC control efforts.