Comparing the five-year relative survival trends of cervical cancer in Puerto Rico and the United States (2000–2021): A joinpoint analysis

Background The five-year relative survival (RS) for cervical cancer in Puerto Rico and the United States (US) is less than 70%. To assess survival trends in the past decades, we compared the five-year RS of cervical cancer in Puerto Rico and in the US. Methods Data was obtained from the Puerto Rico Central Cancer Registry and the Surveillance, Epidemiology, and End Results Program. We included microscopically confirmed cases of cervical carcinoma between 2000 and 2021. The five-year RS trends were analyzed with Joinpoint regression models using the JPSurv software, which estimated the Average Absolute Change in Survival (AAC_S). Results Puerto Rico showed a lower five-year RS than US overall across the study period. In the US, the AAC_S was - 0.78 for patients diagnosed between 2000 and 2003 (95%CI: - 1.32 to - 0.23), - 0.22 for 2003–2013 (95%CI: - 0.36 to - 0.08), and 0.25 for 2013–2021 (95%CI: 0.01–0.49). In Puerto Rico, the AAC_S was - 0.03 for 2000–2011 (95%CI: - 0.56–0.51), 1.71 for 2011–2016 (95%CI: 0.60–2.83), and - 1.10 for 2016–2021 (95%CI: - 3.12–0.92). Conclusion Puerto Rico shows poorer cervical cancer five-year RS than the US. Increased five-year RS was observed in the US overall population after 2013. In Puerto Rico, improvements in five-year RS were observed after 2011, but these were halted after 2016. This finding may suggest that barriers to accessing care during periods of extreme events, such as the convergence of the 2017 hurricanes and the 2020 COVID-19 pandemic challenges, likely affected survival trends from 2016 to 2021. Future research should further characterize barriers to improve cervical cancer survival.