Right to Life - Archive

Cervical Cancer Incidence, Mortality, and Screening — United States, 2007–2012 (2014)

Since the introduction and widespread use of the Papanicolaou (Pap) test in the 1950s in the United States, cervical cancer incidence and mortality have decreased dramatically (1,2).

In addition to screening with a Pap test alone every 3 years, recent cervical cancer screening recommendations now include the use of the human papillomavirus (HPV) test (used to detect infection with oncogenic HPV types associated with cervical cancers) with the Pap test among women aged 30–65 years every 5 years (1,3).

Despite evidence that cervical cancer screening saves lives, the incidence and death rates from cervical cancer remain substantial, especially among populations with limited access to care (4). Over half of all new cases occur in women who have never or rarely been screened (5)…

… A more thorough understanding of the etiologic role of HPV in cervical cancer has provided the foundation for targeted approaches for prevention, including … HPV-based screening.

However, regardless of the improvement in prevention methods, most cervical cancer occurs in women who have not had recent screening

… Cervical cancer incidence rates are higher for black and Hispanic women than for white women, and death rates are higher for black women (available at http://www.cdc.gov/uscs)…

Background: Cervical cancer screening is one of the greatest cancer prevention achievements, yet some women still develop or die from this disease.

Objective: To assess recent trends in cervical cancer incidence and mortality, current screening percentages, and factors associated with higher incidence and death rates and inadequate screening.

Methods: Percentages of women who had not been screened for cervical cancer in the past 5 years were estimated using data from the 2012 Behavioral Risk Factor Surveillance System survey. State-specific cervical cancer incidence data from the United States Cancer Statistics and mortality data from the National Vital Statistics System were used to calculate incidence and death rates for 2011 by state. Incidence and death rates and annual percentage changes from 2007 to 2011 were calculated by state and U.S. Census region.

Results: In 2012, the percentage of women who had not been screened for cervical cancer in the past 5 years was estimated to be 11.4%; the percentage was larger for women without health insurance (23.1%) and for those without a regular health care provider (25.5%).

From 2007 to 2011, the cervical cancer incidence rate decreased by 1.9% per year while the death rate remained stable.

The South had the highest incidence rate (8.5 per 100,000), death rate (2.7 per 100,000), and percentage of women who had not been screened in the past 5 years (12.3%).

Conclusions: Trends in cervical cancer incidence rates have decreased slightly while death rates have been stable over the last 5 years. The proportion of inadequately screened women is higher among older women, Asians/Pacific Islanders, and American Indians/Alaska Natives.

Implications for Public Health Practice: There continue to be women who are not screened as recommended, and women who die from this preventable cancer. Evidence-based public health approaches are available to increase women’s access to screening and timely follow-up of abnormal results.

[CDC, MMWR Weekly, November 7, 2014 / 63(44);1004-1009, http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6344a5.htm?s_cid=mm6344a5_e ]