GLOBAL Epidemiological Findings
The continent of Africa has the second highest rate of cervical cancer after America.In Africa, the incidence of HPV and related cancers (vaginal, vulvar and cervical) is highest among the other regions. Maximum number of HPV cases along with HIV has been reported by the number of studies. In current review, the highest levels of cervical cancer have been found in Swaziland with the incidence rate of 36.0/100,000 womenper year followed by Zimbabwe (34.5) and Tanzania (30.6)(13). The most prevalent genotypesin Africa are HPV 16 and 18, followed by 35, 6 and 45. Apart from cervical cancer, vaginal and vulvar cancers are low incident and are only reported in Algeria, Egypt, Libya, South Africa, Zimbabwe and Mali. In swaziland, the first case of HPV was reported in 1983 and the incidence increases from 16.6% in to 36% up until 2012(14). After Swaziland, the outbreaks extended to different regions of African continent including Tanzania in 1985 (15), Zimbabwe in 1990(16), Namibia in 1992(17), Algeria and Morocco in 1993(18, 19), Senegal in 1994(20), Guinea in 1997(21) and Angola in 2000 (22). In 2008, two epidemics were recorded in Libya and South Africa with 4090 and 2000 cases respectively (23, 24).
In Asia, cervical cancer is highly prevalent in Taiwan with the incidence rate of 33.5 cases per 100,000 women, followed by Kazakhstan (32.8). The prevalent genotypes are 16 and 18, followed by 52 and 58. The first outbreak was detected in Magnolia in 1982 causing cervical cancer and progressed into other Asian regions(25). Other cancers including vaginal and vulvar were detected in China, Korea, Thailand, Philippines, Vietnam, Pakistan, India, Bahrain, Turkey, Israel, Kuwait and Qatar. After magnolia, HPV have been detected in Korea in 1985 (26) Japan in 1994 (27),and Kazakhstan in1999 (28) which then spreads to other regions of Asia. In 2002, India, Bahrain and Turkey reach the peak of its HPV prevalence (29-31) followed by an outbreak in Singapore during the year 2008 (32). In Asian continent, the lowest prevalence of HPV has been detected in different countries throughout the world including Kuwait, Qatar, Turkey, Bahrain, Israel and Pakistan.