Age-specific incidence and mortality of cervical cancer in the Czech Republic – analysis of nationwide data and data from a gynecologic oncology center

Česká verze

Authors: K. Robová ^1,2 ; Tomáš Pichlík ^1,2 ; Lukáš Rob ^1,2 ; Helena Robová ^1,2 ; Nikola Janovská ^1,2 ; R. Tachezy ³ ; Michael Jiří Halaška ^1,2
Authors place of work: Gynekologicko-porodnická klinika 3. LF UK a FNKV, Praha ¹; Onkogynekologické centrum, FNKV Praha ²; Katedra genetiky a mikrobiologie, PF UK, BIOCEV, Vestec u Prahy ³
Published in the journal: Ceska Gynekol 2026; 91(1): 61-68
Category: Přehledová práce
doi: https://doi.org/10.48095/cccg202661

Summary

Objective: To analyze the incidence and mortality of cervical cancer in individual age cohorts in the Czech Republic using nationwide data and data from the largest national gynecological oncology center. Materials and methods: Analysis of a single-institution cohort of newly treated cervical cancer cases from 2022–2024, and analysis of incidence and mortality trends in individual age groups using data from the Czech National Cancer Registry (ÚZIS –⁠ Institute of Health Information and Statistics) from 2000–2023. Results: The incidence and mortality of cervical cancer in the Czech Republic have declined significantly over the last 20 years. The decline correlates well with measures that have led to better organization and implementation of changes within the screening program. Analysis in individual age cohorts shows that the largest decline in incidence and mortality occurred in the cohort up to 34 years of age, yet in more than 50% of women with carcinomas in this cohort, cytological screening and subsequent management failed. The upward trend in incidence in the 35–44 and 45–54 age cohorts raises questions about the causes. The high percentage of invasive carcinomas in women examined by a gynecologist in the last three years requires an analysis of the quality of cytology laboratories and management by registering gynecologists. The introduction of high-risk human papillomavirus (HR HPV) testing and referral to expert colposcopy for discrepant findings is one way to improve the situation. Furthermore, audits of diagnosed carcinomas in women who have undergone screening should be introduced. The biggest challenge will be to activate the resistant population of women who underestimate the importance of regular screening examinations. Conclusion: Even though we can see an overall decline in incidence and mortality, when individual age cohorts are analyzed, it shows us ways for improvement in each specific age group of women individually.

Keywords:

incidence – cervical cancer – screening – mortality – cytology quality – HR HPV testing

Zdroje

1. World Health Organization. WHO guideline for screening and treatment of cervical pre-cancer lesions for cervical cancer prevention. 2021 [online]. Available from: https: //www.who.int/publications/i/item/9789240030824.

2. Sehnal B, Sláma J. Jak dále ve screening karcinomu děložního hrdla. Ceska Gynekol 2020; 85 (4): 236–243.

3. Bosch FX, Lorincz A, Muñoz N et al. The causal relation between human papillomavirus and cervical cancer. J Clin Pathol 2002; 55 (4): 244–265. doi: 10.1136/jcp.55.4.244.

4. Maver PJ, Poljak M. Primary HPV-based cervical cancer screening in Europe: implementation status, challenges, and future plans. Clin Microbiol Infect 2020; 26 (5): 579–583. doi: 10.1016/j.cmi.2019.09.006.

5. Tatar O, Wade K, McBride E et al. Are health care professionals prepared to implement human papillomavirus testing? A review of psychosocial determinants of human papillomavirus test acceptability in primary cervical cancer screening. J. Womens Health (Larchmt) 2020; 29 (3): 390–405. doi: 10.1089/jwh.2019.7678.

6. Tota JE, Bentley J, Blake J et al. Introduction of molecular HPV testing as the primary technology in cervical cancer screening: acting on evidence to change the current paradigm. Prev Med 2017; 98 : 5–14. doi: 10.1016/ j.ypmed.2016.11.029.

7. Rob L, Tachezy R, Robova H. Cervical cancer: what is the optimal age for routine testing? Future Oncol 2015; 11 (8): 1137–1140. doi: 10.2217/fon.15.42.

8. Kinkorová Luňáčková I, Májek O. Karcinom děložního hrdla v ČR a možnosti jeho prevence. Cesk Patol 2018; 63 (4): 164–168.

9. Bray F, Laversanne M, Sung H et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2024; 74 (3): 229–263. doi: 10.3322/caac.21834.

10. Hejcmanová K, Ambrožová M, Chloupková R et al. Pokrytí cílové populace cervikálním screeningovým vyšetřením v tříletém intervalu. Národní zdravotnický informační portál. Praha: Ministerstvo zdravotnictví ČR a Ústav zdravotnických informací a statistiky ČR. 2025 [online]. Available from: https: //www.nzip.cz/datova-sada/233.

11. Hejcmanová K, Dianová T, Chloupková R et al. Podíl žen s provedeným hr-HPV testem v cílových věkových skupinách. Národní zdravotnický informační portál. Praha: Ministerstvo zdravotnictví ČR a Ústav zdravotnických informací a statistiky ČR. 2025 [online]. Available from: https: //www.nzip.cz/data/2330-cervix -⁠ podil-hpv-otevrena-data.

ORCID autorů

K. Robová 0009-0000-8778-0465

T. Pichlík 0000-0001-6732-1421

L. Rob 0000-0003-3770-651X

H. Robová 0000-0002-6136-7602

N. Janovská 0009-0006-5832-7702

R. Tachezy 0000-0001-7689-97271

M. J. Halaška 0000-0001-6055-2569

Doručeno/Submitted: 27. 8. 2025

Přijato/Accepted: 13. 10. 2025

MUDr. Karolína Robová

Gynekologicko-porodnická klinika