Trends and projections in cervical cancer incidence in northern Tunisia (1994–2040)

Background: Cervical cancer (CC) is a major public health problem; it is the fourth leading cause of cancer in women worldwide. The present study aimed to analyze trends and projections in incidence of CC in northern Tunisia during the period 1994–2040. Methods: Crude and Age standardized CC incidence were calculated. Joinpoint software was used to dress trends in incidence. Projections were assessed using the age period cohort model. Results: This study revealed 3092 cases of CC during the period 1994–2018 in northern Tunisia, representing an annual number of 129. The mean age at diagnostic was of 56 ± 12.9 years with extremes ranging from 19 to 88 years old. The crude and standardized incidence rates were respectively of 4.9/100,000 and 5.2 /100,000 women year in 2018. A downward trend in the age standardized incidence rate of CC was confirmed in northern Tunisia from 6.6 in 1994 to 4.7 in 2018 with an Annual Percentage Change (APC) of -1.8%, Confidence interval (CI) at 95% of [-2.9; -0.6]; (p = 10− 3). Trends analysis have also described three periods: the first one from 1994 to 1998 with a stable trend. The second period was from 1998 to 2006 with a significant decreasing trend with an APC of -7.2%, CI at 95% of [-13.0; -1.0]; (p = 0.02) and the third period was from 2006 to 2014 with a non-significant APC. According to projections, the number of new cases would be of 2017 in 2040 with an age standardized rate between 3.8 and 5.8/100,000 women year. Conclusion: Results of this study underscore the need for the application of CC control program in Tunisia, with efforts focused on improving access to and participation in screening programs, HPV vaccination for females and ensuring timely access to effective treatment services. © The Author(s) 2025.