Advanced cervical cancer rising fastest among White women in the South

HPV vaccination can prevent cervical cancer. CDC data shows vaccination rates by geographical region – source US Centers for Disease Control and Prevention

CANCER DIGEST – Aug. 21, 2022 – While the number of cases of advanced cervical cancer, cancer that has spread beyond the cervix, is highest among Black women, it is rising faster in White women than any other racial group, according to a new analysis in the Aug. 18, 2022 International Journal of Gynecological Cancer.

The study also showed that while such cancer is relatively rare, there was no racial/ethnic group, age group, or region where the number of cases of advanced cervical cancer has fallen over the past 18 years. Those most at risk were Black women aged 55 to 59 years living in the South with a rate of 2.6 per 100,000, nearly double the rate (1.39 per 100,000) of same aged White women in the South.

The study analyzed data from the US Cancer Statistics program and national surveys of screening and vaccination during the period of 2001 to 2018. During that time 29,715 women were diagnosed with advanced cervical cancer.

After adjusting for age, the researchers, led by Alex Andrea Francoeur of the Department of Obstetrics and Gynecology at the University of California, Los Angeles, showed that cases of early stage disease fell by an annual rate of 1.6%, while cases of advanced disease rose by 1.5% per year.

When they sorted those diagnosed with advanced disease by race, geographical region, and age, the data showed that the steepest annual rise in stage IV cervical cancer was among White women in the South aged 40-44, with a rate of 4.5%.

In addition, the data showed that Black women were nearly twice as likely to be screened for cervical cancer with a rate of 26.5% compared to 14% for White women, and HPV vaccination rates was lowest among White women aged 13-17, while the greatest increase in annual vaccination rates was 7% among Black teens.

The researchers acknowledged that a limitation of their study was a lack of a national screening and vaccination registry for cervical cancer causing them to rely on multiple sources of data that could have affected their findings.

Nevertheless, the researchers concluded that, "Over 90% of cervical cancer is caused by HPV (human papilloma virus); the lower rate of vaccination among White women, coupled with non-guideline screening in this population could explain the trend toward higher rate of increase in distant disease in White women."

The authors added that their findings demonstrate the public health need to vaccinate more young women and girls against HPV infection.


Sources: British Medical Journal press release and the International Journal of Gynecological Cancer