Trends in the incidence of cancers of the breast and female genital tract in Harare, Zimbabwe 1990-2019.

Trends in age standardised incidence rates (ASRs) in the black (African) female population of Harare are reported for five cancers-of the breast and genital tract (cervix and corpus uteri, ovary and vulva) over a 30-year period. The incidence of cervix cancer is very high (ASR of 73.7 per 10) and has increased at a rate of 1% annually over the period, although remaining stable in the most recent 15 years; the increase involves mainly women born between 1950 and 1970. Breast cancer rates are less than half those of cervix, but the increase has been more dramatic-3% annually-although this seems to involve only women aged over 40. The incidence of ovarian cancer has been constant over the 30 years; there was a small increase in the incidence of cancer of the corpus uteri (1.5% annually) and a more marked one for vulvar cancer (5.6% annually), for which the incidence is relatively high, by global standards. Concurrent with the increasing incidence of cancers of the breast and corpus uteri are notable trends of population risk factors such as rising obesity rates and declining fertility. The elevated burden of cervix and vulvar cancers aligns with patterns observed in populations with high HPV prevalence, though population-specific data remain limited. The results confirm that cancers associated with increasingly affluent lifestyles (breast and corpus uteri) are increasing, although the incidence of cancer of the cervix-an eminently preventable cancer-remains persistently high and is clearly a priority for cancer control.