TRENDS IN CERVICAL-CANCER MORTALITY IN SOUTH-AFRICA

Background. Cervical cancer is an important cause of death throughout the world, especially in less developed countries. Reports of trends i n cervical cancer mortality from less developed countries have been li mited by poor data quality and inaccurate population estimates. This p aper examines trends in cervical cancer mortality in South Africa from 1949 to 1990 and discusses the impact of cytology screening on these trends. Method. Analysis of national mortality statistics and reconstr ucted population data. Results. The age-standardized mortality rates f or Whites declined after the mid 1960s, while that for coloureds rose, particularly before the 1970s. These trends were affected predominant ly by trends among women in the 35-64 age range. Conclusion. The patte rn of mortality in successive birth cohorts for Whites is consistent w ith a reduction in age-specific mortality following the advent of cyto logical screening. The same pattern is not evident in trends for Colou reds, among whom screening has apparently had a minor impact if any at all. The apparent lack of impact of screening in those groups of wome n most at risk of cervical cancer lends weight to demands for the Impl ementation of equitable and rational screening programmes for cervical cancer in South Africa and internationally.