Recent Anatomical Trends in Cervical Cancer in Sri Lanka (2015–2022): Predominance of Endocervical and Overlapping Lesions and Implications for Screening

Objective: The anatomical distribution of cervical cancer is central to the effectiveness of screening and treatment. Age-related migration of the transformation zone into the endocervical canal alters lesion accessibility and detection. Recent national data allow reassessment of cervical cancer anatomy in the contemporary era. The objective of the study was to describe recent trends (2015–2022) in the anatomical distribution of cervical cancer in Sri Lanka and examine their implications for screening and management.
Methods: Population-based cervical cancer registry data from 2015–2022 were analyzed. Tumors were classified by anatomical subsite using ICD-O topography codes as endocervix, exocervix, overlapping lesion, or cervix not otherwise specified (NOS). Temporal patterns were examined descriptively.
Results: Among anatomically specified cervical cancers, endocervical cancers consistently outnumbered exocervical cancers throughout 2015–2022. Overlapping lesions increased during this period, while a large proportion of cases remained coded as NOS.
Conclusion: Recent data demonstrate a predominance of endocervical and anatomically complex cervical cancers in Sri Lanka. This distribution reflects cervical morphological change with age and presents inherent challenges to ectocervix-focused screening approaches.