Abstract
Abstract
Introduction
Cervical cancer remains a leading cause of morbidity and mortality among women in Uzbekistan, exceeding WHO elimination targets. Despite a school-based HPV vaccination program launched in 2019, screening coverage remains low, leading to delayed diagnoses; we examined cervical cancer trends in Tashkent (2014–2024) to evaluate the impact of the Korea Foundation for International Healthcare (KOFIH) screening project and UNFPA/UNDP HPV testing initiatives.
Methods
We analyzed Tashkent City Oncoregister data for women diagnosed with invasive cervical cancer or carcinoma in situ (CIS) between 2014 and 2024 (n = 2,140) after data cleaning. We calculated age-standardized incidence and mortality rates, assessed survival using Kaplan–Meier methods, and identified mortality predictors using Cox regression models.
Results
The age-standardized incidence of invasive cervical cancer was 14.9 per 100,000. After KOFIH and UNFPA/UNDP implementation, CIS diagnoses increased 3.4-fold (0.2 to 4.7 per 100,000), while the proportion of advanced-stage (III–IV) disease declined by 43%. Five-year survival showed clear stage dependence, ranging from 91.5% for CIS to 27.8% for stage IV. Age and stage were independent predictors of mortality. Crude mortality declined from 10.2 to 1.1 per 100,000 from 2014 to 2024, and case fatality decreased from 48.6% (2014–2019) to 27.2% (2020–2024).
Conclusion
Organized screening through KOFIH and UNFPA initiatives can improve early detection and reduce mortality. However, 76.6% of staged invasive cases remain advanced (II–IV), and more than 80% of women have never been screened, underscoring the need to expand screening, sustain HPV vaccination, and strengthen prevention programs in Central Asia.