Supakorn Pitakkarnkul

The situation of gynecological cancers in Thailand: incidence, histopathology, and survival outcomes from national cancer registry data

Cervical, uterine, and ovarian cancers are the 3 main cancers of the female reproductive system. Analyzing data from the cancer registry database will help understand the situation and trends of these diseases. This study utilized data from Thailand's population-based cancer registries covering 16 provinces across 5 geographic regions between 2019 and 2021. Data collection included demographic characteristics, cancer incidence, histopathology, disease stage, and survival outcomes. Incidence rates were calculated using age-standardized rates (ASRs) per 100,000 population, and 5-year survival outcomes were compared across 2 time periods (2013-2017 vs. 2018-2022). During 2019-2021, Thailand recorded a mean annual ASR of 132.9 for females, with cervical cancer remaining the most common gynecologic cancer. The incidence of cervical cancer decreased from 19.5 per 100,000 in 1995-2000 to 10.3 per 100,000 in 2019-2021. Uterine cancer demonstrated a rising trend, from 3.6 per 100,000 in 2004-2006 to 6.1 per 100,000 in 2019-2021, while ovarian cancer incidence remained relatively stable at 5.9 per 100,000. Five-year survival rates improved significantly across all gynecologic cancers in 2018-2022 compared with 2013-2017. The hazard ratios for overall survival by stage ranged from 0.57 to 0.81 for cervical, 0.53 to 0.82 for uterine, and 0.57 to 0.81 for ovarian cancers (all p<0.05). The incidence of cervical cancer in Thailand has declined over the past 2 decades, while the burdens of uterine and ovarian cancers are increasing. Five-year survival rates have significantly improved across all gynecologic cancer types.

Knowledge of Thai women in cervical cancer etiology and screening

Knowledge about cervical cancer screening and Human papilloma virus (HPV) influence on their awareness to the cervical cancer screening program. Most previous studies found inadequate knowledge and attitude among healthy women affect the low rate of screening. This study aimed to assess knowledge of cervical cancer screening and HPV in women who had abnormal cervical cancer screening in Bangkok. Thai women, aged ≥ 18 years old, who had abnormal cervical cancer screening and scheduled to colposcopy clinics of 10 participating hospitals were invited to participate in this cross-sectional study. The participants were asked to complete a self-answer questionnaire (Thai language). The questionnaire composed of 3 parts: (I) demographic data, (II) knowledge about cervical cancer screening and (III) knowledge about HPV. Among 499 women who answered the questionnaires, 2 had missing demographic data. The mean age of the participants was 39.28 ± 11.36 years. 70% of them had experience of cervical cancer screening, with 22.7% had previous abnormal cytologic results. Out of 14 questions, the mean score of knowledge about cervical cancer screening was 10.04 ± 2.37. Only 26.9% had good knowledge about cervical cancer screening. Nearly 96% of woman did not know that screening should be done. After excluding 110 women who had never known about HPV, 25.2% had good knowledge about HPV. From multivariable analysis, only younger age (≤ 40 years) was associated with good knowledge of cervical cancer screening and HPV. In the conclusion, only 26.9% of women in this study had good knowledge regarding cervical cancer screening. Likewise, 20.1% of women who had ever heard about HPV has good knowledge about HPV. Providing information about cervical cancer screening and HPV should improve the women’s knowledge and better adherence to the screening procedure.