Health Risk Trends Among Women in Central Serbia: Cancer Patterns and Implications for Disaster and Public Health Preparedness

Background/Objectives: Disaster Risk Management in Serbia must account for cancer as a signifi-cant public health burden and a critical dimension of long-term health system resilience. This study aims to identify long-term spatial and temporal trends in cancer incidence and mortality among women in Central Serbia, focusing on eight leading cancer types: breast, cervical, uterine, colorectal, bladder, ovarian, pancreatic, and lung/bronchial cancers. By examining these patterns across 18 counties from 1999 to 2021, the study seeks to provide an evidence base for targeted prevention, early detection, and health system preparedness. Methods: Standardized incidence and mortality rates were extracted from national datasets and analysed using the non-parametric Mann-Kendall trend test and Sen's slope estimator. Trend significance was determined at 95% and 99% confidence levels. Spatial analysis was conducted using ArcGIS Pro 3.2, which enabled the visualisation of geographic disparities. Due to data limitations, mortality trends were analysed only for cancer types with statistically reliable time series. Results: The analysis revealed an increasing incidence trend for breast cancer in six counties. In contrast, cervical cancer showed decreasing incidence and mortality trends in several areas, likely reflecting successful screening efforts. Rising incidence rates for colorectal, bladder, pancreatic, and lung/bronchial cancers were observed across numerous counties, with lung and bronchial cancer mortality increasing in 16 counties—indicating a growing systemic burden. Meanwhile, mortality from breast, cervical, and colorectal cancers decreased in some regions, suggesting improved treatment outcomes. Disparities between counties underline regional vulnerabilities in healthcare infrastructure and access. Conclusions: The findings underscore the need for regionalised public health strategies, strengthened data systems, and interdisciplinary collaboration to reduce cancer-related disparities and build resilience against public health risks. These insights are vital for aligning cancer control programs with disaster preparedness frameworks, especially in resource-constrained settings.