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Cervical cancer

ICD-10 C53
2017

¹ per 100,000 persons, age-standardised according to the old European standard population

* calculated using the period method for 2015 / 2016

Women
Incidence4,341
Age-standardised incidence rate¹8.7
Deaths1,587
Age-standardised mortality rate¹2.5
5-year prevalence16,600
10-year prevalence30,700
Relative 5-year survival rate*67 %
Relative 10-year survival rate*63 %

In Germany, approximately 4,341 women were diagnosed with invasive cervical cancer in 2017. It is important to distinguish here between a localised tumour that has not yet invaded the surrounding tissue (in situ carcinoma) and a fully developed cancer from which metastases can develop (invasive cancer). In about seven out of ten cases of invasive cervical cancer, the tumour originates from the squamous epithelial tissue of the cervical mucosa. Adenocarcinomas, in contrast, tend to originate in the higher-lying transition between the uterine body and cervix.

The incidence rates for invasive cervical cancer in women have been largely stable over the last 15 years, after a very sharp decline in the preceding three decades. Approximately four out of ten diagnoses occur at an early tumour stage (stage I).

Age-standardised incidence and mortality rates, ICD-10 C53, Germany 1999 – 2016/2017, projection (incidence) through 2020, per 100,000 (old European standard population). Source: © German Centre for Cancer Registry Data at the Robert Koch Institute Age-standardised incidence and mortality rates, ICD-10 C53, Germany 1999 – 2016/2017, projection (incidence) through 2020, per 100,000 (old European standard population)

The average age at diagnosis of invasive carcinoma is 55 years. The much more frequent in situ carcinomas are usually discovered in women who are on average 20 years younger at early detection examinations.

In total, approximately 1,587 women in Germany currently die of cervical cancer every year; 30 years ago, the number was more than twice as high. The relative 5-year survival rate after diagnosis of an invasive cervical tumour is 67 percent.

Internationally, new cases and mortality rates in countries with long-standing, well-organized screening programs are substantially lower than in countries without such programs.

Viruses increase risk of cancer

The main cause of cervical cancer is a persistent infection with sexually transmitted human papillomaviruses (HPV). An asymptomatic HPV infection is common and usually resolves without consequences. Persistent infection with high-risk viruses such as HPV 16 and 18 can lead to the development of cervical cancer. Additional risk factors are smoking, other sexually transmitted pathogens (e.g. herpes simplex, chlamydia), early onset of sexual activity, a large number of births and a severely weakened immune system. The long-term use of oral contraceptives (birth control pills) also slightly increases the risk of the disease. Certain hereditary factors may promote the development of cervical cancer.

What early detection and prevention measures are available?

The statutory early detection programme in Germany offers an annual gynaecological examination and cervical cell smear (PAP smear) for women between the ages of 20 and 34 years. Starting in 2020, women 35 years and older are offered an HPV test combined with the PAP smear every three years in addition to an annual gynaecological examination. The Standing Committee on Vaccination (STIKO) recommends that girls and boys be vaccinated against HPV, ideally between the ages of 9 and 14 years. Up to the age of 17 years, statutory health insurance covers the costs of a catch-up vaccination. Vaccination does not replace early detection, as current vaccines do not protect against all high-risk HP viruses.

Date: 21.04.2021

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