Advanced cervical cancer on the rise, study finds: 'Not an easy explanation'

Advanced cervical cancer on the rise, study finds: ‘Not an easy explanation’

Late-stage cervical cancer rates are rising in the U.S. with the strongest increases in white women, though the disease’s prevalence is still highest in black women, a new study finds.

An analysis of data from nearly 30,000 women diagnosed with advanced disease revealed that black women had a prevalence nearly 60% higher than white women. Researchers found that advanced adenocarcinoma, the form with the lowest survival rate, increased nearly twice as fast in white women as in black women, according to the report published in the International Journal of Gynecological Cancer: 3.4% per year among white women compared to 1.71% among black women.

“Paradoxically, if we look at early-stage cancer, we see it has decreased, but if you look at metastatic stage IV cervical cancer, the opposite is true: the rates have increased,” said the study’s lead author. , dr. Alex Francoeur. , a fourth-year OB-GYN resident at the University of California, Los Angeles.

“Unfortunately, there is no easy explanation for how this can be improved.”

The strongest increase in late-stage cervical cancer, 4.5% per year, occurred in Southern white women ages 40 to 44 — a group who would have been too old to have been vaccinated against HPV, the virus that can cause cervical cancer.

Part of the explanation for the sharp increase in late-stage cervical cancer in white women could be the lower screening rates, Francoeur said. She and her colleagues found that compared to black women, white women were almost twice as likely to be not screened at all or not screened at all in accordance with clinical guidelines, resulting in a gap of five or more years between Pap tests.

To take a closer look at trends in late-stage cervical cancer rates, Francoeur and her colleagues turned to data from 2001 to 2018 from the Centers for Disease Control and Prevention’s National Program of Cancer Registries and the National Cancer Institute’s Surveillance, Epidemiology and Final results program. Data on the extent of cervical cancer screening comes from the Behavioral Risk Factor Surveillance System, a national system of health-related telephone surveys.

Of the 29,715 women diagnosed with advanced cervical cancer between 2001 and 2018, the prevalence was higher among black women than among white women: 1.55 per 100,000 versus 0.92 per 100,000. The researchers found that there was a total increase of 1.3% per year in late-stage cancer. The largest increase was in cervical adenocarcinomas, which were increasing at an annual rate of 2.9% per year.

While the researchers weren’t able to look at the screening histories of the women with late-stage cancer, it’s reasonable to assume the lack of screening is to blame, said Dr. Stephanie Blank, a professor at the Icahn School of Medicine at Mount Sinai and director of gynecologic oncology for the Mount Sinai Health System.

“It’s such a shame,” Blank said. “Unfortunately, this is a disease that disproportionately affects under-resourced and underinsured communities. We really need a system to help people get both the vaccine and the screening. Only by improving access to these life-saving tools can these trends be reversed.”

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