Fewer American women are being diagnosed with early-stage cervical cancer, but advanced cases that are often fatal are becoming more common and are disproportionally impacting Black and white women, according to a new study
For the study, researchers examined government data on more than 31 million U.S. cancer cases between 2001 and 2018, as well as national survey data on screening and vaccination for cervical cancer. During the study period, a total of 29,715 patients were diagnosed with advanced cervical cancer, according to study results published in the International Journal of Gynecological Cancer.
Diagnosis of advanced cervical cancer increased by 1.3 percent annually during this time frame, even as diagnosis of early-stage cases declined by 1.59 percent a year.
Advanced cervical cancer rates rose fastest among white women, by 1.69 annually. The steepest annual increase in diagnosis rates was 4.5 percent — among white women in the South between 40 and 44 years old. Diagnosis also climbed by 0.67 percent annually among Black women, the study found.
Black people also had the highest prevalence of advanced cervical cancer cases, at 1.55 cases per 100,000 women compared with 0.92 cases per 100,000 white women.
“This study reaffirms continued well-known racial disparities in distant stage cervical cancer,” the study team wrote.
Distant, or advanced, cervical cancer has spread beyond the pelvis to the bladder, rectum, or other parts of the body. It’s relatively rare, but has few treatment options, and a five-year survival rate of just 17 percent, the researchers noted. Early-stage cervical cancer has a five-year survival rate of 92 percent.
By far the biggest risk factor for cervical cancer is the sexually transmitted human papillomavirus (HPV), according to the U.S. Centers for Disease Control and Prevention (CDC). The HPV vaccine protects against the types of HPV that most often cause cervical cancer, and is recommended for all preteens and unvaccinated individuals up to 26 years old.
Among teens 13 to 17 years old, white patients had the lowest cervical cancer vaccination rates, at 66.1 percent. By contrast, vaccination rates reached 75.3 percent among Hispanic teens, 74.6 percent among Black youth, and 68.1 percent among Asian teens, the study found.
Women should get routine cervical cancer screenings starting at age 25, according to the American Cancer Society. Screening should be done every three to five years, depending on the type of test used to examine cervical cancer tissues for abnormalities.
Without screening, it can be hard to catch cervical cancer early because it often has no symptoms until it’s advanced and hard to treat, according to the CDC. Symptoms of advanced cervical cancer can include bleeding or discharge from the vagina, such as bleeding after sex, that’s different from what people normally experience.
In the study, 26.6 percent of white patients didn’t get recommended cervical cancer screenings, compared with 13.8 percent of Black patients.
The lower vaccination and screening rates among white patients may explain why this group experienced the steepest increase in advanced cervical cancer cases, the study team concluded.