Not All Cervical Cancer Rates Are Declining


A type of cervical cancer that’s less sensitive to Pap testing is increasing among white women in the United States, new research shows.

An overall decline in cervical cancer rates in recent decades has been driven by decreases in squamous cell carcinomas. Most of the rest of cervical cancer cases are adenocarcinomas, which are less likely to be detected by Pap testing and are mainly caused by the human papillomavirus (HPV).

The investigators found that squamous cell carcinoma rates continued to decrease in all racial/ethnic groups except whites. Rates in white women stopped falling in the 2010s.

Rates of adenocarcinoma were stable between 1999 and 2002, but rose among whites by 1.3% a year between 2002 and 2015. Those increases were driven by sharp increases among women aged 40 to 49 (4.4% per year increase since 2004) and women aged 50 to 59 (5.5% per year increase since 2011).

Adenocarcinoma rates fell among blacks and Hispanics between 1999 and 2015, and were stable in Asian/Pacific Islanders, according to the report.

“Increasing or stabilized incidence trends for [adenocarcinoma] and attenuation of earlier declines for [squamous cell carcinoma] in several subpopulations underscore the importance of intensifying efforts to reverse the increasing trends and further reduce the burden of cervical cancer in the U.S.,” Dr. Farhad Islami and colleagues wrote in a cancer society news release.

“More efforts are needed to increase screening utilization according to guidelines and appropriate follow-up of positive results” to further reduce cervical cancer rates, the study authors added.

While increased use of HPV testing may improve early detection of adenocarcinoma, research is needed to further improve screening strategies to reduce overdiagnosis, which may be more common with HPV testing, Islami’s team said.

“Our results also underscore the importance of HPV vaccination. Concerted efforts are needed to increase its use, which remains suboptimal,” the researchers concluded.


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