Over the past two decades, cases of pre-cancer and early stage cervical cancer have declined significantly thanks to improved screening and HPV vaccination efforts. However, new research shows that rates of advanced stage cervical cancer diagnoses are rising at an alarming rate.
Advanced Cancer Rates Increase Over Last Two Decades
According to a recent study from the American Cancer Society, cervical cancer is one of the only cancers that has seen an increase in advanced stage diagnoses since the early 2000s, even as medical advances have driven down rates for other cancers. Between 2001-2017, the incidence of regional and distant stage cervical cancers increased by over 2% per year.
This trend is particularly pronounced among white and Black women under the age of 50. For example, distant stage cervical cancer increased by 3.4% per year among white women ages 30-34 and by 3.9% among Black women ages 35-39.
| Age Group | Average Annual Percent Change in Distant Cervical Cancer |
|---|---|
| 30-34 years old | 3.4% (white women) |
| 35-39 years old | 3.9% (Black women) |
The reasons for the rise are complex, but lack of access to preventative healthcare and failure to follow up on abnormal test results are likely major contributing factors.
Falling Rates of Screening Enables Cancer Progression
Cervical cancer is highly preventable through regular screening that catches precancerous changes early on. When abnormal cells are found and treated, invasive cervical cancer can almost always be prevented from developing.
However, screening rates have dropped substantially in recent years. A recent study found pap test rates declined from around 70% to under 50% among women ages 21-29 over the 2000s. It’s a concerning trend that researchers believe has enabled more cases to progress to later stages before being caught.
Declines are especially steep among minorities and uninsured women. One study found 38% of uninsured women had not had a pap test within the past three years. This lack of access could help explain the rise in advanced cancers among minority groups.
Even when tests are done regularly, follow up care is critical. Upwards of 50% of women do not receive follow-up tests after an abnormal pap result. According to Dr. Kathleen Schmeler of MD Anderson Cancer Center, “If you don’t have the next test, you don’t know if the precancerous lesion…has progressed to an invasive cancer.” Failure to follow up appears to play a major role in the cancer progression being witnessed.
HPV Vaccination Lagging Despite Recommendations
Another key tool for preventing cervical cancer that remains underutilized is the HPV vaccine. HPV infection is responsible for nearly all cases of cervical cancer. Yet vaccination rates still lag national targets more than 15 years after the first HPV vaccine was introduced.
CDC recommendations are that 100% of boys and girls receive the multi-dose HPV vaccine by age 15. However, only around 60% of teens are up to date. Adult vaccination rates remain extremely low as well.
| Metric | HPV Vaccination Rate |
|---|---|
| Teens up to date | ~60% |
| Adult vaccination rate | Extremely low |
There are signs coverage is slowly rising after plateauing in recent years. But millions remain vulnerable to HPV infection and lagging vaccination among boys also inhibits herd immunity.
Public Health Efforts Seek to Reverse Trends
January is Cervical Cancer Awareness Month, and public health leaders are using the occasion to sound the alarm about rising advanced diagnosis rates. Efforts are underway to increase public knowledge and encourage those at risk to get screened and vaccinated.
For example, the state of Arkansas has declared January Cervical Cancer Awareness Month statewide. Many other states have announced expanded health services aimed at boosting screening rates among uninsured women.
There has also been a push to publicize the importance of HPV vaccination for both girls and boys. Missouri is considering eliminating allowances for parents to opt out of school-mandated HPV vaccination based on reasons other than medical necessity. Studies show states without nonmedical exemption saw faster increases in HPV vaccination coverage.
Many cancer centers and women’s health networks are also hosting informational events to teach the public about prevention and early warning signs. For example, common symptoms like pelvic pain and unusual bleeding can indicate precancerous changes. Catching these early makes treatment more effective.
The Path Ahead
Despite having the knowledge and tools to effectively prevent cervical cancer, cases of advanced stage diagnosis continue to climb among American women. Turning the tide will require attacking the problem from multiple angles.
Better insurance coverage and access to affordable screening are critically needed to detect more cervical abnormalities at early, treatable stages. Public health campaigns can also help raise awareness and vaccination rates to stop cancer from developing in the first place.
Policy changes eliminating non-medical vaccination opt-outs and improved patient monitoring/recall systems for follow up care could have an impact as well.
Many of the barriers are social and economic rather than medical. Tackling issues like healthcare access and vaccine hesitancy across broader segments of the population will be key to reversing the rise in cervical cancer incidence long-term.
To err is human, but AI does it too. Whilst factual data is used in the production of these articles, the content is written entirely by AI. Double check any facts you intend to rely on with another source.
