Trends in net survival from cervical cancer in a Brazilian state with medium Human Development Index

Sep 23, 2026

Cervical cancer remains a major public health concern in Northeast Brazil. A population-based study estimates net survival for invasive cervical cancer in Sergipe, a Brazilian state with a medium Human Development Index, using high-quality cancer registry data (women aged 15–99) diagnosed from 1996 to 2017 and followed to 2022. Net survival was calculated with the Pohar Perme method, stratified by histological subtype and calendar period, and age-standardised with International Cancer Survival Standard weights. Results show a marked decline over time, with one-year and five-year net survival decreasing between early and late periods, and persistent declines across squamous and adenocarcinoma subtypes. The findings suggest later detection of more advanced invasive cancers, emphasizing the need to improve screening and timely access to care.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages9

Reading Time23 min

AccessFree to download

Background and study rationale

Cervical cancer burden and prevention

Histological types and clinical features

Methods

Data source and study population

Case definition and histological grouping

Statistical approach (net survival)

Results

Overall time trends in net survival

Survival patterns by histological subtype

Discussion and implications

[www. nature.com/scientificreports](www. nature.com/scientificreports) OPEN Trends in net survival from cervical cancer in a Brazilian state with medium Human Development Index Brenda Evelin Barreto da Silva1,5􀀍, Veronica Di Carlo2, Pamela Minicozzi2, Naomi Ssenyonga2, Fatima Khan Baloch2, Melissa Matz2, Michel P. Coleman2, Claudia Allemani2 & Carlos Anselmo Lima1,3,4 Cervical cancer remains a major public health concern in Northeast Brazil, ranking as the second most common cancer among women. This study provides the first long-term, population-based estimates of net survival from cervical cancer in Sergipe, a Brazilian state with a medium Human Development Index, using high-quality registry data subjected to rigorous quality control procedures. We analysed data for 3,977 women aged 15–99 years diagnosed with an invasive cervical cancer between 1996 and 2017 and followed up to 2022, after excluding 6,095 in situ neoplasms. Net survival was estimated using the Pohar Perme method, stratified by histological subtype and calendar period, and agestandardised with the International Cancer Survival Standard weights. We observed a substantial decline in survival over time: one-year net survival dropped from 84.6%(1996–1999) to 73.4%(2015–2017), and five-year survival from 60.8 to 49.3% . Squamous cell carcinoma and adenocarcinoma showed similar survival patterns, with five-year survival ranging from 55 to 58%. The persistent decline in net survival may reflect a shift toward more advanced or aggressive invasive cancers, as screening programmes increasingly detect and remove early-stage lesions. Delayed diagnosis and sub-optimal treatment further contribute, underscoring the need to improve screening and timely cancer care access. Keywords Cervical cancer, Epidemiology, Population-based survival, Histology, Brazil Cervical cancer is the most common gynaecological cancer worldwide1. Despite the availability of preventive measures such as Human Papilloma Virus (HPV) vaccination and regular screening with the Pap smear, limited awareness of the disease and obstacles in access to health services persist, leading to ongoing disparities in the disease burden2. Squamous cell carcinoma and adenocarcinoma are the most common histological types. Squamous cell carcinoma is characterised by slower growth. Adenocarcinoma arises from glandular cells; it tends to display amore aggressive growth pattern, and is often diagnosed at an advanced stage3,4. Globally, cervical cancer ranks fourth in both incidence and cancer-related deaths among women, with a significant public health impact in low-income and middle-income countries1. In Brazil, the epidemiological profile of cervical cancer varies between regions. Incidence of invasive cervical cancer is higher in the North and Northeast, where there is a lower socioeconomic profile, more restricted access to health services and lower education levels5,6. Despite a decline in cervical cancer incidence rates in the state of Sergipe7Northeast Brazil, limited access to health services and socioeconomic disparities remain as persistent barriers to effective disease control. A comprehensive understanding of the impact of this cancer is essential for the strategic planning and implementation of effective interventions. 1Health Sciences Graduate Programme, Federal University of Sergipe, Aracaju, Sergipe, Brazil. 2Cancer Survival Group, Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK. 3Aracaju Cancer Registry, Aracaju, Sergipe, Brazil. 4University Hospital, Federal University of Sergipe, Ebserh, Aracaju, Sergipe, Brazil. 5Federal University of Sergipe, Cláudio Batista Street, Aracaju 49060-100, Sergipe, Brazil. 􀀍 email: [brendaevelinbarreto@gmail.com](brendaevelinbarreto@gmail.com) [www. nature.com/scientificreports/](www. nature.com/scientificreports/) Population-based survival analyses (net survival) are essential for evaluatin

FAQs

What does the study estimate for cervical cancer patients in Sergipe?

It estimates net survival for invasive cervical cancer over time, using long-term, population-based registry data.

How is net survival calculated in this research?

Net survival is estimated using the Pohar Perme method, stratified by histological subtype and calendar period, and age-standardised with International Cancer Survival Standard weights.

What major trend is observed in survival over time?

Survival declines substantially over time, with both one-year and five-year net survival decreasing from the earlier diagnosis period to the later period.

Sep 23, 2026

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