Despite notable advancements in cancer screening and treatment, cancer remains a global issue with significant mortality. Disparities in incidence, mortality, and survival persist, particularly in low- and middle-income countries (LMICs) [1], [2]. This inequality is evident among women in underprivileged regions with inadequate healthcare systems, contributing to preventable cancer cases and deaths [3].

Globally, for 2020, approximately 8.75 million new cases of cancers in women were estimated, with around 4.4 million deaths. Approximately 1.4 million cases were related to gynaecological cancers (GC), namely cervical, uterine, ovarian, vulvar, and vaginal cancers, leading to approximately 670,000 female deaths [1].

Cervical cancer (CC) is the most common GC, primarily caused by persistent high-risk human papillomavirus (HPV) infection [4], [5]. It ranks as the fourth most diagnosed cancer and the fourth leading cause of cancer-related deaths among women, with a disproportionate burden in LMICs [1].

In Brazil, CC stands as the third most common cancer in women, with an estimated average age-standardised incidence rate (ASIR) of 13.25 cases per 100,000 women for 2023–2025 and an average age-standardised mortality rate (ASMR) of 4.51 per 100,000 in 2021 [6], [7]. The North and Northeast regions demonstrate the highest ASIR, reaching 16.77 and 13.85 per 100,000, respectively. Specifically, Sergipe, a state in the Northeast, reports an estimated ASIR of 13.85 per 100,000 [6].

A study conducted in Aracaju, capital of Sergipe, displayed a decline in trends in incidence and mortality of invasive CC from 1996 to 2015, likely attributed to screening strategies [8]. A decrease in cervical precursor lesions was also noted, with uncertainty surrounding the cause, whether it stems from reduced incidence or alterations in screening practices. This uncertainty prompts concerns regarding potential future rises in invasive CC rates in Sergipe. Another previous study on trends in cancer mortality rates in Sergipe, revealed a CC ASMR of 6.4 deaths per 100,000 women from 2014 to 2018 [9].

Corpus uteri cancer (CUC) and ovarian cancer (OC) have higher incidence rates in high income countries (HIC) compared to LMICs [1]. In Brazil, CUC and OC have an estimated ASIR of 4.13 and 5.01 per 100,000 women, respectively. In Sergipe, both CUC and OC have ASIR slightly higher than the national average, at 6.29 and 5.09 per 100,000 women, respectively [6].

Other GC, such as vulvar cancer (VUC), vaginal cancer (VAC), placental cancer (PC), and cancer of unspecified female genital organs, are much less common. VUC and VAC are mainly caused by HPV infection, and together [10], they accounted for less than 1% of all cancers diagnosed in women worldwide and around 4.5% of GC [1].

This study is the first to provide a comprehensive analysis of GC incidence and mortality trends in Sergipe, a medium Human Development Index (HDI) state in northeastern Brazil, over a 22-year period (1996–2017). By focusing on Sergipe, it addresses a critical need to enhance our understanding of female reproductive system cancers' epidemiology. The study's findings are expected to offer valuable insights for evidence-based interventions and public health strategies, benefiting not only Sergipe but potentially serving as a model for regions with similar HDI profiles.