Trends in cervical cancer incidence and mortality in Mongolia, 2014-2024: a population-based analysis of pandemic-related disruptions.

BACKGROUND: Cervical cancer remains a major public health concern in Mongolia, where screening coverage is estimated at approximately 38%, well below recommended levels, and access to timely diagnosis varies. This study examined temporal trends in incidence and mortality and assessed the impact of COVID-19-related disruptions on cancer detection. METHODS: A nationwide population-based study was conducted using data from Mongolia's national health information system (H-Info). All cervical cancer cases (ICD-10: C53.0-C53.9) and related deaths from 2014 to 2024 were included. Age-standardized incidence (ASIR) and mortality rates (ASMR) were calculated using the WHO world standard population as reference. Temporal trends were analyzed using log-linear and segmented regression models. The mortality-to-incidence ratio (MIR) was used as an ecological indicator of population-level cancer outcomes. RESULTS: A total of 3,990 cases and 1,370 deaths were identified. Incidence increased between 2014 and 2016, declined thereafter, and dropped sharply during 2020-2022 (APC -29.4%), before rebounding in 2023-2024. In contrast, mortality declined gradually over the study period. MIR increased during the pandemic and declined following service recovery. CONCLUSIONS: Cervical cancer incidence in Mongolia is highly sensitive to disruptions in screening and diagnostic services. Divergent trends between incidence and mortality likely reflect reduced detection during the pandemic rather than true changes in disease burden. These findings highlight the importance of maintaining continuity of cancer screening and diagnostic services during health-system disruptions.