The high burden of cervical cancer in Fiji, 2004–07
Irwin Law A B H , James J. Fong C , Eka M. Buadromo C , Josaia Samuela C , Mahomed S. Patel A , Suzanne M. Garland D E , E. Kim Mulholland F G and Fiona M. Russell B
+ Author Affiliations
- Author Affiliations
A National Centre for Epidemiology and Population Health, Australian National University, Acton, ACT 0200, Australia.
B Centre for International Child Health, Department of Paediatrics, University of Melbourne, Australia Murdoch Childrens Research Institute, Royal Children’s Hospital, Parkville, Vic. 3052, Australia.
C Ministry of Health, Suva, Fiji.
D Department of Obstetrics and Gynaecology, University of Melbourne, The Royal Women’s Hospital and Murdoch Childrens Research Institute, Parkville, Vic. 3052, Australia.
E Regional WHO HPV Reference Laboratory, Department of Microbiology and Infectious Disease, The Royal Women’s Hospital, Parkville, Vic. 3052, Australia.
F London School of Hygiene and Tropical Medicine, University of London, Keppel Street, London, WC1E7HT, UK.
G Menzies School of Health Research, Charles Darwin University, Darwin, NT 0811, Australia.
H Corresponding author. Email: irwin.law@rch.org.au
Sexual Health 10(2) 171-178 https://doi.org/10.1071/SH12135
Submitted: 16 August 2012 Accepted: 2 December 2012 Published: 5 April 2013
Abstract
Background: There are few population-based data on the disease burden of cervical cancer from developing countries, especially South Pacific islands. This study aimed to determine the incidence and mortality associated with cervical cancer and the coverage of Papanicolaou (Pap) cervical cytology in 20- to 69-year-old women in Fiji from 2004 to 2007. Methods: National data on the incident cases of histologically confirmed cervical cancer and the associated deaths, and on Pap smear results were collected from all pathology laboratories, and cancer and death registries in Fiji from 2004 to 2007. Results: There were 413 incident cases of cervical cancer and 215 related deaths during the study timeframe. The annualised incidence and mortality rates in 20- to 69-year-old Melanesian Fijian women, at 49.7 per 100 000 (95% confidence interval (CI): 43.7–56.4) and 32.3 per 100 000 (95% CI: 26.9–38.4) respectively, were significantly higher than among 20- to 69-year-old Indo-Fijian women at 35.2 per 100 000 (P < 0.001, 95% CI: 29.5–41.7) and 19.8 per 100 000 (P = 0.002, 95% CI: 15.1–25.5) respectively. Of 330 cases diagnosed between 2004 and 2006, 186 (56%) had died by 31 December 2006. Pap smear coverage for this period was 8.0% (95% CI: 7.9–8.1) of the target population. Conclusions: The incidence and mortality related to cervical cancer in Fiji is high, whereas Pap smear coverage is very low. Greater investment in alternative screening strategies and preventive measures should be integrated into a comprehensive, strategic cervical cancer control program in Fiji.
Additional keywords: epidemiology, human papillomavirus, Pap smear, South Pacific.
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