# Incidence Trends and Geographic Variations of Corpus Uteri and Cervical Cancer in Taiwan, 1995–2022: A Population-Based Study

## TL;DR

Cervical cancer rates in Taiwan have dropped due to screening, while uterine cancer rates have risen over 30 years, highlighting changing public health needs.

## Contribution

The study provides long-term population-based evidence on diverging trends of cervical and uterine cancer incidence in Taiwan.

## Key findings

- Cervical cancer incidence in Taiwan decreased significantly from 20.06 to 6.78 per 100,000 women between 1995 and 2022.
- Uterine cancer incidence increased substantially, rising from 2.91 to 17.42 per 100,000 women during the same period.
- Screening programs likely contributed to cervical cancer decline, while generational risk factors may explain rising uterine cancer rates.

## Abstract

Cervical cancer and cancer of the uterine body show opposite trends in many countries, but long-term population-based evidence from Asia remains limited. Using cancer registry data from Taiwan between 1995 and 2022, we examined how the incidence of these two cancers has changed over time and whether patterns differed by age, birth cohort, geographic region, and urbanization level. We found that cervical cancer incidence has declined substantially over the past three decades, a pattern that is compatible with the long-term impact of organized screening programs, whereas cancer of the uterine body has increased steadily across generations. These contrasting trends underscore the differing public health challenges posed by cervical and uterine body cancers. Our findings provide important population-level evidence to inform future cancer prevention strategies and healthcare planning.

Background/Objectives: To examine long-term incidence trends of cervical cancer and corpus uteri cancer in Taiwan from 1995 to 2022, with emphasis on age–period–cohort patterns and regional variation. Methods: Data from the Taiwan cancer registry were analyzed. Age-standardized incidence rates (ASRs) were calculated using the 1976 World Standard Population. Temporal trends were evaluated using Joinpoint regression to estimate annual percent changes (APCs) and average annual percent changes (AAPCs). Age–period–cohort modeling was applied to assess net drift, cohort effects, and period effects. Subgroup analyses were conducted by geographic region and urbanization level. Results: Cervical cancer incidence declined markedly, with ASRs decreasing from 20.06 to 6.78 per 100,000 women between 1995 and 2022 (AAPC = −4.43%, 95% CI: −5.39 to −3.45). In contrast, corpus uteri cancer incidence increased substantially, with ASRs rising from 2.91 to 17.42 per 100,000 women (AAPC = 6.32%, 95% CI: 5.86–6.78). Age–period–cohort analysis revealed a negative net drift for cervical cancer (−5.0% per year) and a positive net drift for corpus uteri cancer (6.1% per year). Cohort effects indicated decreasing cervical cancer risk among women born after 1960, whereas corpus uteri cancer risk increased in successive younger cohorts. Period effects showed pronounced declines in cervical cancer incidence after 2000, patterns that are compatible with the implementation of organized screening, while corpus uteri cancer continued to rise. Conclusions: Cervical cancer incidence in Taiwan has declined substantially over the past three decades, a pattern that is compatible with the long-term impact of organized screening programs. In contrast, the increasing burden of corpus uteri cancer may be associated with generational shifts in metabolic and reproductive risk factors.