Cases of cervical cancer are rising sharply among women in low-income regions of the country, a new study found, threatening decades of progress.
Rates of cervical cancer have plummeted in recent years, thanks to new advances in screening and treatment, most notably HPV vaccines, which were approved in 2006.
But rates have been rising sharply among non-Hispanic white women in low-income areas. The study from researchers at the University of Texas MD Anderson Cancer Center showed an increase of 4.4 percent a year beginning in 2007.
Cervical cancer mortality also increased among the same demographic, likely signifying that the increase wasn’t just because more cancers were being detected, though it wasn’t statistically significant.
“This is really a reversal of the downward trend that we had previously seen,” said co-senior author Jane Montealegre, associate professor of behavioral science. “And more disturbingly, the rates aren't necessarily increasing for localized cancer, or even sort of that regional cancer that responds really well to treatment.”
Conversely, non-Hispanic Black women in low-income counties saw declines in cervical cancer cases but have experienced a 2.9 percent increase in mortality each year since 2013, according to the study.
Across racial/ethnic groups, cervical cancer incidence in 2019 was greater among women living in low-income counties, with the highest absolute incidence observed among Hispanic women in low-income counties.
Researchers used data from the National Cancer Institute between 2000-2019 to examine occurrences of cervical cancer diagnoses and deaths. They also analyzed race and ethnicity and county-level median household income, with the low-income counties ranging from $19,330 to $38,820.
The findings add further evidence to widening disparities driven by socioeconomic status. Cervical cancer is preventable, and the study shows that the increase is likely due to lack of access to vaccination, screening and treatment.
“This is really indicating that there are disruptions in terms of screening, and also probably in terms of follow up, after women have a positive screening test, disrupting them actually getting the diagnostic care and the treatment that they need,” Montealegre said.
The study noted it would be consistent with an overall decreased screening uptake in the country, with declines beginning in the early 2000s, particularly among low-income uninsured women.
More than half of women diagnosed with cervical cancer have either never been screened or haven’t been screened in the past five years, according to the Centers for Disease Control and Prevention.
The U.S. Preventive Services Task Force recommends screening women ages 21-29 with Pap smears every three years. HPV vaccines target the human papillomavirus, which can cause cervical cancer. The shot is given to adolescents, so women in their 20s who were the first to receive the shot in 2006 may not have been represented in the study's data.
According to a new report from the American Cancer Society, there was a 65 percent drop in cervical cancer incidence among women aged 20 to 24 from 2012 to 2019.
"We're really seeing that we need to scale up our efforts for screening, and that's going to be what's going to get us to eliminate cervix cancer as a public health problem faster," Montealegre said. "And then of course, over the long term, the vaccine is going to really ensure that the younger ages don't have to be worried about a cancer like cervical cancer."
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