Background
Previous studies indicate that cervical cancer is the second most frequent cancer and most common cause of cancer mortality among women in Fiji. There is little published data on the epidemiology of cervical cancer in Pacific countries.

Aims
To determine the incidence 2003–2009 of, and mortality 2003–2008 from, cervical cancer by ethnicity and period in Fiji, identify evidence of secular change and relate these data to other Pacific countries, Australia and New Zealand.

Methods
Counts of incident cervical cancer cases (2003–2009) and unit record mortality data (2003–2008) from the Fiji Ministry of Health were used to calculate age‐standardised (to the WHO World Population) cervical cancer incidence and mortality rates, and cervical or uterine cancer mortality rates, by ethnicity, with 95% confidence intervals. On the basis of comparison of cervical cancer mortality with cervical or uterine cancer mortality in Fiji with similar populations, misclassification of cervical cancer deaths is unlikely.

Results
There is no evidence of secular change in cervical cancer incidence and mortality rates for the study period. For women of all ages and ethnicities, the age‐standardised incidence rate of cervical cancer (2003–2009) was 27.6 per 100 000 (95% CI 25.4–29.8) and the age‐standardised mortality rate (2003–2008) was 23.9 per 100 000 (95% CI 21.5–26.4). The mortality/incidence ratio was 87%. Fijians had statistically significant higher age‐standardised incidence and mortality rates than Indians. Fiji has one of the highest estimated rates of cervical cancer incidence and mortality in the Pacific region.

Conclusion
Cervical cancer screening in Fiji needs to be expanded and strengthened.