Primary Submission Category: Place/Communities
State-Level Cervical Cancer Incidence Changes in the United States, 2001-2021
Authors: Ryan Suk, Yenan Zhu, Xiangren Wang,
Presenting Author: Ryan Suk*
Background: Evidence suggests that the previously declining US cervical cancer incidence plateaued in the past decade, coinciding with decreased screening uptake. However, state-level variations in cervical cancer incidence temporal changes remain unclear.
Methods: The 2001-2021 National Program of Cancer Registries (NPCR) and Surveillance, Epidemiology, and End Results (SEER) dataset was used. We included cases that met the inclusion criteria of microscopically confirmed adenocarcinomas and squamous cell carcinomas of the cervix, diagnosed in female individuals aged 20 years or older. Incidence rate ratios (IRRs) comparing incidence rates in 2001-2005 with those in 2017-2021 were calculated, stratified by diagnosis age group and race and ethnicity, and age-adjusted to the 2000 US standard population.
Results: Overall, cervical cancer incidence significantly declined (IRR = 0.88; 95% confidence interval [CI] = 0.87-0.89). However, we observed state-level variations; 24 states experienced statistically significant decreases, 22 states had non-significant decreases, and 5 states had non-significant increases. Remarkably, Oklahoma exhibited a significant increase in the 30-44 years (IRR = 1.17; 95% CI = 1.01-1.37) and 45-64 years (IRR = 1.21; 95% CI = 1.03-1.41) age groups. Kansas (30-44 years: IRR = 1.26; 95% CI = 1.04-1.53), Indiana (45-64 years: IRR = 1.22; 95% CI = 1.06-1.40), and Wyoming (45-64 years: IRR = 1.96; 95% CI = 1.18-3.32) also showed significant increases in some age groups. Among non-Hispanic White (NHW) individuals, Mississippi had a significantly increased rate (IRR = 1.22; 95% CI = 1.02-1.45), while 13 other states showed non-significant increases, including Louisiana, where both NHW and Hispanic individuals exhibited non-significant increases.
Discussion: Greater efforts are needed in states where cervical cancer incidence remains stable or is increasing, focusing on tailored interventions to enhance screening uptake and HPV vaccination.