{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T01:37:41Z","timestamp":1789177061692,"version":"build-2803163510"},"reference-count":40,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2022,2,17]],"date-time":"2022-02-17T00:00:00Z","timestamp":1645056000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: There were 1,335,503 newly diagnosed cases of the most common gynecological cancers in women (cervical, uterine and ovarian cancer) worldwide in 2020. The main objective of this paper was to assess temporal changes in incidence rates of the most common gynecological cancers and to determine the age group with the greatest increase in incidence in the Serbian female population in the period 2003\u20132018. Material and Methods: Trends and annual percentage change (APC) of the incidence rate with corresponding 95% confidence intervals (CI) were calculated by Joinpoint regression analysis. The trend was considered to be significantly increasing (positive change) or decreasing (negative change) when the p-value was below 0.05 (p &lt; 0.05). Results: The total number of newly registered cancer cases from 2003 to 2018 was 35,799. There was a significant increase of age standardized rate (ASR) for all cancer incidences in women from 2012 to 2018 with APC 6.9% (95% CI from 0.9 to 13.3, p = 0.028) and for uterine cancer during the 2014\u20132018 period with APC of 16.8% (95% CI: from 4.0 to 31.1, p = 0.014), as well as for ovarian cancer incidence in the 2012\u20132018 period with APC of 12.1% (95% CI: from 6.7 to 17.8, p &lt; 0.001). A non-significant decrease of ASRs of incidence for cervical cancer was determined from 2003 to 2015 with APC of \u22120.22% (95% CI: from \u22123.4 to 3.1, p = 0.887) and a non-significant increase of ASRs incidence from 2015 to 2018 with APC of 14.21% (95% CI: from \u221213.3 to 50.5, p = 0.311). The most common gynecological cancers were present in all age groups and only ovarian cancer was registered in the youngest age group (0\u20134 years). Cervical cancer showed a typical increase after the age of 30, with peak incidence in women aged 40\u201344 and 65\u201369 years. The increased incidence trend regarding age for cervical cancer (y = 1.3966x + 0.3765, R2 = 0.3395), uterine cancer (y = 1.7963x \u2212 5.4688, R2 = 0.5063) and ovarian cancer (y = 1.0791x \u2212 0.8245, R2 = 0.5317) is statistically significant. Conclusion: Based on our presented results, a significant increase of incidence trend for the most common gynecological cancers in the Serbian female population from 2012 to 2018 was determined. There has been a significant increase in the incidence of uterine cancer from 2014 up to 2018, as well as for ovarian cancer from 2012 up to 2018, while cervical cancer showed a non-significant decrease of incidence trend from 2003 until 2015 and then a non-significant increase. In women below 20 years of age, ovarian cancer was significantly more prevalent, while cervical cancer was significantly more prevalent in the age groups 20\u201339 and 40\u201359 years. In the age group of 60\u201379, uterine cancer had a significantly higher incidence than the other two cancers. Measures of primary prevention, such as vaccination of children against Human Papilloma Virus and screening measures of secondary prevention, for the female population aged 25 to 64 years of age are needed, as well as educating females about healthy lifestyles via media and social networks to help prevent the most common gynecological cancers.<\/jats:p>","DOI":"10.3390\/medicina58020306","type":"journal-article","created":{"date-parts":[[2022,2,17]],"date-time":"2022-02-17T20:25:45Z","timestamp":1645129545000},"page":"306","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Temporal Changes in Incidence Rates of the Most Common Gynecological Cancers in the Female Population in Central Serbia"],"prefix":"10.3390","volume":"58","author":[{"given":"Miodrag M.","family":"Stojanovic","sequence":"first","affiliation":[{"name":"Faculty of Medicine Nis, University of Nis, 18000 Nis, Serbia"},{"name":"Institute for Public Health Nis, 18000 Nis, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8472-9282","authenticated-orcid":false,"given":"Natasa K.","family":"Rancic","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Nis, University of Nis, 18000 Nis, Serbia"},{"name":"Institute for Public Health Nis, 18000 Nis, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7595-3450","authenticated-orcid":false,"given":"Marija R.","family":"Andjelkovi\u0107 Apostolovi\u0107","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Nis, University of Nis, 18000 Nis, Serbia"},{"name":"Institute for Public Health Nis, 18000 Nis, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2689-8088","authenticated-orcid":false,"given":"Aleksandra M.","family":"Ignjatovi\u0107","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Nis, University of Nis, 18000 Nis, Serbia"},{"name":"Institute for Public Health Nis, 18000 Nis, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dijana R.","family":"Stojanovic","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Nis, University of Nis, 18000 Nis, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vesna R.","family":"Mitic Lakusic","sequence":"additional","affiliation":[{"name":"Institute for Emergency Medical Aid, 81110 Podgorica, Montenegro"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mirko V.","family":"Ilic","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Nis, University of Nis, 18000 Nis, Serbia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,2,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"209","DOI":"10.3322\/caac.21660","article-title":"Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"71","author":"Sung","year":"2021","journal-title":"CA A Cancer J. Clin."},{"key":"ref_2","unstructured":"Ferlay, J., Ervik, M., Lam, F., Colombet, M., Mery, L., Pi\u00f1eros, M., Znaor, A., Soerjomataram, I., and Bray, F. (2020). Global Cancer Observatory: Cancer Today. Int. Agency Res. Cancer, Available online: www.Gco.iarc.fr\/today."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"394","DOI":"10.3322\/caac.21492","article-title":"Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"68","author":"Bray","year":"2018","journal-title":"CA Cancer J. Clin."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"444","DOI":"10.1158\/1055-9965.EPI-16-0858","article-title":"Global cancer in women: Burden and trends","volume":"26","author":"Torre","year":"2017","journal-title":"Cancer Epidemiol. Biomark. Prev."},{"key":"ref_5","unstructured":"American Cancer Society (2019, December 15). Risk Factors for Cervical Cancer. Available online: https:\/\/www.cancer.org\/cancer\/cervical-cancer\/causes-risks-prevention\/risk-factors.html."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1638","DOI":"10.1002\/ijc.32956","article-title":"Cervical cancer burden in Latin America and the Caribbean: Where are we?","volume":"147","author":"Pilleron","year":"2020","journal-title":"Int. J. Cancer"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1016\/j.ejca.2019.12.013","article-title":"Effect of organised cervical cancer screening on cervical cancer mortality in Europe: A systematic review","volume":"127","author":"Jansen","year":"2020","journal-title":"Eur. J. Cancer"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1016\/j.ypmed.2017.12.002","article-title":"Is the recent increase in cervical cancer in women aged 20\u201324 years in England a cause for concern?","volume":"107","author":"Castanon","year":"2018","journal-title":"Prev. Med."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"2144","DOI":"10.1002\/ijc.32014","article-title":"Increasing risk of uterine cervical cancer among young Japanese women: Comparison of incidence trends in Japan, South Korea and Japanese-Americans between 1985 and 2012","volume":"144","author":"Utada","year":"2019","journal-title":"Int. J. Cancer"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"437","DOI":"10.1002\/ijc.30695","article-title":"Cost-effectiveness of cervical cancer screening methods in low- and middle-income countries: A systematic review","volume":"141","author":"Mezei","year":"2017","journal-title":"Int. J. Cancer"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1532","DOI":"10.1001\/jama.2020.16244","article-title":"Lifetime prevalence of cervical cancer screening in 55 low- and middle-income countries","volume":"324","author":"Lemp","year":"2020","journal-title":"JAMA"},{"key":"ref_12","first-page":"69","article-title":"Knowledge about cervical cancer, Pap test, and barriers to women\u2019s participation in screening in Belgrade, Serbia","volume":"38","author":"Jovanovic","year":"2017","journal-title":"Eur. J. Gynaecol. Oncol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1177\/0969141320902482","article-title":"Cervical cancer screening and prevention in Kazakhstan and Central Asia","volume":"28","author":"Aimagambetova","year":"2020","journal-title":"J. Med. Screen."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1038\/s41416-020-0831-9","article-title":"Trends in cervical cancer incidence in sub-Saharan Africa","volume":"123","author":"Joko","year":"2020","journal-title":"Br. J Cancer"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1759","DOI":"10.1038\/bjc.2011.430","article-title":"Cancer incidence in the United Kingdom: Projections to the year 2030","volume":"105","author":"Mistry","year":"2011","journal-title":"Br. J. Cancer"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"386","DOI":"10.1186\/s12967-020-02554-y","article-title":"Endometrial cancer: Mapping the global landscape of research","volume":"18","author":"Ouassou","year":"2020","journal-title":"J. Transl. Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1089\/jwh.2018.6956","article-title":"Increased Incidence of Endometrial Cancer Following the Women\u2019s Health Initiative: An Assessment of Risk Factors","volume":"28","author":"Constantine","year":"2019","journal-title":"J. Womens Health"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1016\/S0140-6736(08)60269-X","article-title":"Body-mass index and incidence of cancer: A systematic review and meta-analysis of prospective observational studies","volume":"371","author":"Renehan","year":"2008","journal-title":"Lancet"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"56","DOI":"10.4103\/ijmr.IJMR_2023_17","article-title":"Relationship between type of smokeless tobacco and risk of cancer: A systematic review","volume":"148","author":"Gupta","year":"2018","journal-title":"Indian J. Med. Res."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"580","DOI":"10.1038\/bjc.2014.579","article-title":"Alcohol consumption and site-specific cancer risk: A comprehensive dose-response meta-analysis","volume":"112","author":"Bagnardi","year":"2015","journal-title":"Br. J. Cancer"},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Zhang, Y., Luo, G., Li, M., Guo, P., Xiao, Y., Ji, H., and Hao, Y. (2019). Global patterns and trends in ovarian cancer incidence: Age, period and birth cohort analysis. BMC Cancer, 19.","DOI":"10.1186\/s12885-019-6139-6"},{"key":"ref_22","doi-asserted-by":"crossref","unstructured":"Everatt, R., and Intaite, B. (2020). Trends in Mortality Rates of Corpus Uteri and Ovarian Cancer in Lithuania, 1987\u20132016. Medicina, 56.","DOI":"10.3390\/medicina56070347"},{"key":"ref_23","unstructured":"Ministry of Health of Republic of Serbia (2013). National Guide for Diagnosis and Treatment of Cervical Cancer."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"157","DOI":"10.7314\/APJCP.2015.16.1.157","article-title":"Gynaecological Cancer Mortality in Serbia, 1991\u20132010: A Joinpoint Regression Analysis","volume":"16","author":"Ilic","year":"2015","journal-title":"Asian Pac. J. Cancer Prev."},{"key":"ref_25","unstructured":"Institute for Public Health of Serbia Dr. Milan Jovanovic \u201cBatut\u201d (2020). Malignant Tumors in Republic of Serbia 2018, Institute for Public Health of Serbia Dr. Milan Jovanovic \u201cBatut\u201d."},{"key":"ref_26","unstructured":"Sagy, M. (1960). Cancer Mortality for Selected Sites in 24 Countries (1950\u20131957), Tohoku University School of Public Health."},{"key":"ref_27","unstructured":"World Health Organization (2021, June 25). International Classification of Diseases and Related Health Problems, 10th Revision. Available online: www.who.int\/classifications\/icd\/en\/."},{"key":"ref_28","unstructured":"National Programme (2021, December 08). Official Gazette Number 54. Available online: http:\/\/www.slglasnik.com."},{"key":"ref_29","unstructured":"(2021). The 2019 Serbian National Health Survey, Institute of Public Health of Serbia."},{"key":"ref_30","doi-asserted-by":"crossref","unstructured":"Mihajlovi\u0107, J., Pechlivanoglou, P., Miladinov-Mikov, M., \u017divkovi\u0107, S.S., and Postma, M.J. (2013). Cancer incidence and mortality in Serbia 1999\u20132009. BMC Cancer, 13.","DOI":"10.1186\/1471-2407-13-18"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"67","DOI":"10.3802\/jgo.2009.20.2.67","article-title":"Current Status of Gynecologic Cancer in Japan","volume":"20","author":"Ushijima","year":"2009","journal-title":"J. Gynecol. Oncol."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"e7","DOI":"10.3802\/jgo.2018.29.e7","article-title":"Epidemiology of gynecologic cancers in China","volume":"29","author":"Jiang","year":"2018","journal-title":"J. Gynecol. Oncol."},{"key":"ref_33","unstructured":"Bruni, L., Albero, G., Serrano, B., Mena, M., G\u00f3mez, D., Mu\u00f1oz, J., Bosch, F.X., de Sanjos\u00e9, S., and ICO\/IARC Information Centre on HPV and Cancer (HPV Information Centre) (2019, June 17). Human Papillomavirus and Related Diseases. Kazakhstan. Summary Report. Available online: http:\/\/www.hpvcentre.net\/statistics\/reports\/."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Aitken, C.A., van Agt, H.M., Siebers, A.S., van Kemenade, F.J., Niesters, H.G.M., Melchers, W.J.G., Vedder, J.E., Schuurman, R., van den Brule, A.J., and van der Linden, H.C. (2019). Introduction of primary screening using high-risk HPV DNA detection in the Dutch cervical cancer screening programme: A population-based cohort study. BMC Med., 17.","DOI":"10.1186\/s12916-019-1460-0"},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Rancic, N.K., Golubovic, M., Ilic, M., Ignjatovic, A., Zivadinovic, R., Djenic, S., Mom\u010dilovi\u0107, S.D., Koci\u0107, B.N., Milo\u0161evi\u0107, Z.G., and Ota\u0161evi\u0107, S.A. (2020). Knowledge about Cervical Cancer and Awareness of Human Papillomavirus (HPV) and HPV Vaccine among Female Students from Serbia. Medicina, 56.","DOI":"10.3390\/medicina56080406"},{"key":"ref_36","unstructured":"Jovanovic, V. (2015). The Impact of Knolwedge and Attitudes of Women toward Cervical Cancer and Pap Test on Their Participation in Screening. [Ph.D. Thesis, Faculty of Medical Sciences, University of Kragujevac]."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"S222","DOI":"10.1016\/j.ygyno.2005.07.092","article-title":"Awareness of cervical cancer screening among women in Serbia","volume":"99","author":"Kesic","year":"2005","journal-title":"Gynecol. Oncol."},{"key":"ref_38","unstructured":"Ministry of Health of RS (2020). The Rulebook on the Program of Mandatory and Recommended Immunization against Certain Infectious Diseases. Official Gazette of RS."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"1097","DOI":"10.2298\/VSP110629030G","article-title":"Risk factors for epithelial ovarian cancer in the female population of Belgrade, Serbia: A case-control study","volume":"70","author":"Gazibara","year":"2013","journal-title":"Vojn. Pregl."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"1511","DOI":"10.1158\/1055-9965.EPI-17-0290","article-title":"Recent Trends in Ovarian Cancer Incidence and Relative Survival in the United States by Race\/Ethnicity and Histologic Subtypes","volume":"26","author":"Park","year":"2017","journal-title":"Cancer Epidemiol. Biomark. Prev."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/58\/2\/306\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T22:21:20Z","timestamp":1760134880000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/58\/2\/306"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,2,17]]},"references-count":40,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2022,2]]}},"alternative-id":["medicina58020306"],"URL":"https:\/\/doi.org\/10.3390\/medicina58020306","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,2,17]]}}}