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Advanced Cervical Cancer is on the Rise in the US


A new study finds that while cases of early-stage cervical cancer are decreasing, distant-stage cases are on the rise in the US. This could be possibly attributed to missed or lack of guideline screening and low human papillomavirus vaccination rate among some groups.

Researchers from the University of California, Los Angeles (UCLA) analyzed data on 29,715 women from the US Cancer Statistics program from 2001 to 2018. They found an annual increase in distant-stage cervical cancer at a rate of 1.3% per year.

The study reveals that white women in the South aged 40–44 have the highest rise in distant cervical cancer at a rate of 4.5% annually.

However, black women have overall higher rates of late-stage cervical cancer (1.55/100 000) compared to white women (0.92/100 000).

Using the Behavioral Risk Factor Surveillance System and TeenVax data, researchers found that compared with black women, white women almost twice as often miss or lack guideline screening, 26.6% vs. 13.8%, respectively.

At the same time, white teenagers aged 13–17 have the lowest human papillomavirus (HPV) vaccination rate at 66.1%, compared with others at 75.3%.

“Even with screening and vaccination, there is not one racial/ethnic group, a region in the USA, or age group where distant stage cervical cancer has been decreasing over the last 18 years. This study also found that white patients have the lowest rate of childhood HPV vaccination and are the most likely to have nonguideline Pap smear cervical cancer screening, which could contribute to this finding,” the authors conclude.

Symptoms and survival rates

The distant stage cervical cancer has an approximate five-year survival rate of 18%. The American Cancer Society notes that women now being diagnosed with cervical cancer may have a better outlook as treatments improve over time, and these numbers are based on women who were diagnosed and treated at least five years earlier.

Cervical cancer can be prevented by regular screenings, including the Pap and HPV tests:

  • The Pap test (or Pap smear) looks for precancers, cell changes on the cervix that might become cervical cancer if they are not treated appropriately. Women should start getting the Pap test at the age of 21.
  • The HPV test looks for the virus (human papillomavirus) that can cause these cell changes.

The Centers for Disease Control and Prevention (CDC) recommends HPV vaccination for all boys and girls at ages 11-12 to protect against HPV-related infections and cancers, and for everyone through age 26 years if not vaccinated already.

The vaccine, which has been approved by the US Food and Drug Administration since 2006, protects against 90% of HPV strains that can lead to cervical cancer.

Early-stage cervical cancer does not necessarily have symptoms; while any symptoms listed below might be signs of cervical cancer:

  • Blood spots or light bleeding between or following periods
  • Menstrual bleeding that is longer and heavier than usual
  • Bleeding after intercourse, douching, or a pelvic examination
  • Increased vaginal discharge
  • Pain during sexual intercourse
  • Bleeding after menopause
  • Unexplained, persistent pelvic and/or back pain

Resources:

1. International Journal of Gynecological Cancer. The increasing incidence of stage IV cervical cancer in the USA: what factors are related?

2. American Cancer Society. Survival Rates for Cervical Cancer.

3. CDC. What Should I Know About Screening?

4. CDC. Human Papillomavirus (HPV) Vaccine.

5. Cancer.net. Cervical Cancer: Symptoms and Signs.

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