Background The aim of the present study is to describe the temporal trends in mortality rates of cervical cancer in Shandong Province, China, and to elucidate their likely explanations. Methods Three retrospective surveys of all causes of death in —, — and — in Shandong were carried out. An age-period-cohort analysis based on similar survey data from Qixia, a county in Shandong, from to was performed.
A correlation analysis between prevalence of syphilis and cervical cancer mortality rates three decades later was conducted. A cross-sectional survey of risk factors for cervical cancer was conducted in in one city and 12 villages in the province.
Results A marked decline in cervical cancer mortality rates was observed from to and in successive birth cohorts from to , and rates remained relatively constant in subsequent birth cohorts through that of The decline in these rates was strongly correlated with a decline in positive serological tests for syphilis 32 years previously. The percentages of women with selected risk factors were lower in younger women 30—54 years than in older women 55—69 years in both cities and rural areas.
Conclusion These trends are compatible with a decrease in risk of exposure to sexually transmitted factors at an early age after the founding of the People's Republic of China in , and a decline in lifetime duration of exposure to possible co-factors in successive birth cohorts who reached sexual maturity before that time.
In Shandong Province, China, cervical cancer ranked first as a cause of death due to cancer in women between and This study was conducted to determine whether this apparent decrease in rates actually occurred, to determine whether this is a cohort or cross-sectional phenomenon, and to identify possible reasons for this apparent decline.
