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CERVIX CANCER EPIDEMIOLOGY IN MOROCCO AND IN THE WORLD. N. BENJAAFAR; M.A. TAZI; H. ELKACEMI. INTRODUCTION. The second most common cancer in women worldwide:500000/year Cervical cancer is a major public health concern in developing countries: 83% the leading cause of cancer deaths: 85%
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CERVIX CANCER EPIDEMIOLOGY IN MOROCCO AND IN THE WORLD N. BENJAAFAR; M.A. TAZI; H. ELKACEMI
INTRODUCTION • The second most common cancer in women worldwide:500000/year • Cervical cancer is a major public health concern in developing countries: 83% • the leading cause of cancer deaths: 85% • Second female cancer in Morocco and North Africa • First female cancer in most sub-Saharan countries • Natural history very long, HPV the main cause • screening is efficient • Vaccination?
633001 inhabitants in 2005 • Rabat Morocco Population Distribution 3
Population Distribution Grand Casablanca 3 615 903
CERVIX CANCER IN MOROCCO • Second female cancer since 1995 in hospital registries and actually in population based • It occurs commonly at younger ages • Most cases are diagnosed at advanced stages • No planned screening for Women at risk
DATA FROM HOSPITAL REGISTRIES • INO: National cancer centre, 35% cases • COIR, Military Hospital, Oujda, Agadir • Alkindy, Littoral, Alazhar, Nakhil • 16000 patients/ year
CERVIXCANCER,INO : % of total number of patients from 2000 to 2006
Evolution of Breast and Cervix cancer at INO : from 1985 to 2006
Age • median Age = 50 years • Minimum : 23 years • Maximum : 93 years
Pathology • Sc Carcinoma : 90% • Adenocarcinoma : 5% • Sarcoma : 0,5% • Others : 4,5%
DATA FROM POPULATION REGISTRIES • Casablanca, 2004 and Rabat, 2005 • Breast cancer is The leading female cancer and overall: Rabat: ASR: 35.8/100000 33.5% in female Median age: 48 years Casablanca: ASR:35.0/100000 36.1% Median age: 48 years
Data from population registries • Cervix cancer, 2nd female cancer Rabat: ASR:15.4/100000 13.5% Median age: 54 years Casablanca: ASR: 13.5/100000 12.82% Median age: 53.5 years
Principales localisations cancéreuses chez la femme-RCRC 2004. 36,1% Sein Col 12,8% Thyroide 5,3% Ovaires 5% LNH 4% 2,8% Rectum Corps utérin 2,7% Estomac 2,5% 2,3% Peau Colon 2,2% Poumon 1,7% LH 1,6% Vésicule biliaire 1,2% 1,1% Œsophage Autres 16,7%
Data from population registries • Cumulative risk 0-74 years Rabat : 1.9% Casablanca: 1.5% • Pathology Rabat: SCC: 90.2%, Adenocarc: 7.8% Casablanca: SCC: 79%, Adenocarc: 4.7%
Data from population registriesRabat • 93% are invasive, 7% in situ carcinoma • Median age invasive, 54y and in situ, 46y • 12% aged less 40y, Incidence10.7/100000 • The incidence increases with age to a maximum between 65-74years: 90/100000 • 92% were collected from cancer centres • More than 67% are stage II or higher
Uterine cervix cancer, RabatASR:Age group Distribution Age 24
Uterine cervix cancer Comparison With other registries 26
CERVIX CANCER IN THE WORLD Age-standardized Incidence and Mortality Rates for Cervix Uteri Cancer. Data shown per 100,000
CONCLUSION • Cancer du col utérin peut etre évité par un comportement sain et une bonne hygienne • Le dépistage chez les femmes à risque est efficace sur la mortalité et sur l’incidence • Informer la population pour avoir un diagnostic précoce seul garant d’une curabilité