Trends in net survival from cervical cancer in a Brazilian state with medium Human Development Index.

Cervical cancer remains a major public health concern in Northeast Brazil, ranking as the second most common cancer among women. This study provides the first long-term, population-based estimates of net survival from cervical cancer in Sergipe, a Brazilian state with a medium Human Development Index, using high-quality registry data subjected to rigorous quality control procedures. We analysed data for 3,977 women aged 15-99 years diagnosed with an invasive cervical cancer between 1996 and 2017 and followed up to 2022, after excluding 6,095 in situ neoplasms. Net survival was estimated using the Pohar Perme method, stratified by histological subtype and calendar period, and age-standardised with the International Cancer Survival Standard weights. We observed a substantial decline in survival over time: one-year net survival dropped from 84.6% (1996-1999) to 73.4% (2015-2017), and five-year survival from 60.8 to 49.3%. Squamous cell carcinoma and adenocarcinoma showed similar survival patterns, with five-year survival ranging from 55 to 58%. The persistent decline in net survival may reflect a shift toward more advanced or aggressive invasive cancers, as screening programmes increasingly detect and remove early-stage lesions. Delayed diagnosis and sub-optimal treatment further contribute, underscoring the need to improve screening and timely cancer care access.