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Study: Late-Stage Cervical Cancer Rising in White and Black U.S. Women - Prevention Magazine

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  • A new study shows that late-stage cervical cancers are on the rise in U.S. women.
  • Black women were found to be at higher risk for a late-stage cervical cancer diagnosis but the number of white women diagnosed is increasing at a higher annual rate.
  • Cervical cancer, when caught early, is highly treatable. However, late-stage cases have much lower survival rates.

A new research study shows that late-stage cervical cancers are on the rise in the U.S.

The study, published in the International Journal of Gynecological Cancer, explains that cervical cancer stage IVA-B (late stage) is a rare diagnosis with around a 5-year survival rate of 17%—and late-stage cases are on the rise. Unfortunately, late-stage cervical cancer has limited treatment options. The study aimed to evaluate the trends of this late-stage cancer in the U.S. and identify possible factors related to the findings.

Researchers found that over the last 18 years, 29,715 women were diagnosed with late-stage cervical carcinoma (cervical cancer). When examining the trends over time, there has been an 1.3% annual increase in late-stage cervical cancer per year.

The study used data from the United States Cancer Statistics program from 2001 to 2018 to determine the number of late-stage cervical cancer diagnoses across different demographics, including race. Rates of cervical cancer screening and vaccination were evaluated using the Behavioral Risk Factor Surveillance System, a nation’s premier system of health-related telephone surveys that collect state data about U.S. residents regarding their health-related risk behaviors, chronic health conditions, and use of preventive services—and TeenVaxView, which uses surveys and immunization systems to estimate vaccination coverage among teens.

This study found that Black women had disproportionately higher rates of late-stage cervical cancer (1.55 cases per 100,000) whereas white women had fewer (0.92 cases per 100,000). Though, interestingly, when looking at geography and age, 40-44-year-old white women in the South had the highest rise in late-stage cervical cancer with an increase of 4.5% annually.

Researchers found that white women had nearly twice as high a rate of missed or too few guideline screenings, 26.6%, compared to 13.6% of Black women. Meanwhile, white teenagers (13–17 years) had the lowest human papillomavirus (HPV) vaccination rate (a virus passed between all genders, that can cause cervical cancer) of 66.1% compared with other groups at 75.3%.

Ultimately, researchers concluded that Black women are being diagnosed with late-stage cervical cancer at a higher rate than white women. However, the number of cases for white women is increasing more each year than for Black women. And, white women continue to have lower rates of regular cancer screenings and vaccinations than Black women.

So why is the steep incline in cervical cancer especially concerning?

“This study showed increases in numbers of advanced cervical cancer rates and any time we see an increase in cancer rates, it’s worrisome,” says Jessica Shepherd, M.D., OBGYN and women’s health expert. She continues to explain that “with cervical cancer specifically, these results are especially concerning for women because they do not have to be the case. Cervical cancer is preventable through regular screening and, if it’s caught early, it is highly treatable.”

If it’s caught early, it is highly treatable.

Dr. Shepherd warns that once cervical cancer advances, the prognosis becomes worrisome. “The numbers of advanced cervical cancer are rare and 17% of those diagnosed with it will survive at least 5 years compared with 92% of those diagnosed with early-stage disease, which is why there is [a] concern,” making regular screenings that much more vital to catch the cancer as early as possible.

Why are late-stage cervical cancers on the rise?

Though there is no one answer to this question, undoubtedly the decrease in annual checks and vaccinations could play a factor in the increase in late-stage cervical cancers being found. Delaying an exam gives cancerous cells time to grow if they’re present, so staying on top of these doctors appointments is imperative, especially if you’re at a greater risk of cancer.

And the study reinforces the importance of comprehensive, regular cervical cancer screening for women of all ages, races, and ethnicities, according to Dr. Shepherd.

“With disease rates increasing again in certain populations, as well as these new data showing increases in advanced-stage cervical cancer, it’s more important than ever that women get screened—ideally with Pap smear + HPV together, the most comprehensive screening option which catches more cancer than the Pap test or HPV test alone.”

Why are Black and Hispanic women at higher risk of late-stage cervical cancer?

Disparities in healthcare are significant across the board, and this is true with cervical cancer.

“It’s well documented that Black and Hispanic women are at a higher risk for cervical cancer overall, with factors like access to healthcare, quality of care, and access to premier insurance which significantly contributes to the higher rates of both cervical cancer and cervical cancer-related mortality for these women,” says Dr. Shepherd.

She says the data “reinforced that the disparities we know exist—indeed, the prevalence of advanced cervical cancer was highest among Black women. But part of what was so interesting about this study was that it pointed out that the steepest increase in advanced cervical cancer rates was among white women ages 40-44—which is not exactly what we would have expected to see.”

Dr. Shepherd says this is a strong and important reminder that just because someone is not particularly high risk, doesn’t mean they’re not at risk.

What preventative measures can you take against cervical cancer?

One of the best things a woman can do is to stay up to date on her regular well-woman exams, which include screenings for diseases like breast cancer, sexually transmitted infections, and yes, cervical cancer.

Dr. Shepherd says that women should ask their doctor to walk them through each step of their exam so they know what they’re being examined for; and they can specifically ask if they will receive a Pap or Pap+HPV test to screen for cervical cancer, as well as when they’re due for their next test.

The current screening guidelines recommend Pap testing every three years for women 21-29 years old and co-testing (Pap + HPV) every five years for those 30-65 years.

The bottom line

Getting tested early and often is your best weapon against cervical cancer. Especially given that the pandemic has put a hold on many of our routine check-ups, be sure you have a doctor you trust and stay up to date on all of your vaccinations and testing.

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Study: Late-Stage Cervical Cancer Rising in White and Black U.S. Women - Prevention Magazine
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