Why is Late-Stage Cervical Cancer on the Rise in 2023?

The overall rate of cervical cancer in the United States is declining. That's the good news.

The bad news: Late-stage cervical cancer rates are climbing.

Researchers in California analyzed data on nearly 30,000 women from 2001 to 2018 to get a handle on stage 4 cervical cancer trends in the United States. They found an annual 1.3% increase in advanced stages of the disease over those 17 years.

The study, which was published in the International Journal of Gynecologic Cancer, found the greatest increase in late-stage cervical cancer has been found in Black women, with 1.55 in 100,000 diagnosed, and Hispanic women who have a 40% higher rate of diagnosis than white women. These findings are due to healthcare disparities, such as socioeconomic status and access to healthcare. However, white women ages 40 to 44 who live in the South also have the highest risk of late-stage cervical cancer, with rates increasing by 4.5% yearly. This is in part to older Southern women being less likely to receive the HPV vaccine due to lack of information when they were younger. It's reported now that with an increase of knowledge around the HPV vaccine, more women in younger generations will become vaccinated.

Perhaps the most sobering statistic is that the five-year survival rate for women with advance stage cervical cancer is 17%. Conversely, the five-year survival rate for people with cervical cancer that's caught at the earliest stage is more than 90%.

These statistics indicate the need for women to take preventative action to protect themselves against severe cases of cervical cancer.

What causes cervical cancer?

Cervical cancer occurs in the cells of the cervix, which connects the vagina of the uterus. Persistent infection with certain types of human papillomavirus, or HPV, is the leading cause of cervical cancer.

HPV is a common virus that is transmitted during sex. The Centers for Disease Control and Prevention says at least 50% of sexually active people will have HPV at some point in their lives, but few women will develop cervical cancer.

Around 14,000 new cases of invasive cervical cancer will be diagnosed in 2023. Of that number, approximately 4,300 will die from the disease, according to the American Cancer Society.

Cervical cancer usually develops slowly. Before cancer appears in the cervix, abnormal cells begin to take shape in cervical tissue. These changes are referred to as dysplasia. If not removed, these abnormal cells can evolve into cancer cells that can spread.

How do you detect and prevent cervical cancer?

Once one of the most common causes of cancer death for American women, cervical cancer mortality rates have declined significantly over the past several decades with the use of the Pap test. This screening procedure largely prevents cervical cancer and can find changes in the cervix before cancer develops. It can also find cervical cancer in its early stages when it's easier to cure.

The American College of Obstetricians and Gynecologists recommends:

• Women ages 21 to 29 should have a Pap test alone every three years. HPV testing alone can be considered for women 25 to 29.
• Women ages 30 to 65 have three options for testing. They can have both a Pap test and an HPV test every five years. They can have a Pap test alone every three years. Or they can have HPV testing alone every five years.
• After age 65, you can stop having cervical cancer screenings if you have never had abnormal cervical cells or cervical cancer and you've had two or three negative screening tests in a row, depending on the type of test.

The HPV vaccine is also a primary weapon against the disease. It can prevent most cervical cancer cases if given before people are exposed to the virus. It has been extensively studied and found to be both safe and effective.

Why is late-stage cervical cancer on the rise?

The number of new cases and deaths from cervical cancer has been dramatically reduced over the past half-century. However, the National Cancer Institute reports a recent rise in the number of women in the United States who are overdue for cervical cancer screening, a troubling trend that some experts believe explains the increase in late-stage cases.

Researchers who analyzed data on more than 20,000 women found that in 2005 about 14% were overdue for a cervical cancer screening. In 2019, that number rose to 23%, according to the cancer institute.

Lack of knowledge about screening or not knowing they needed to be screened was the most common reason study participants gave for not receiving a Pap test.

Some experts fear the reduced access to health care during the COVID-19 pandemic may lead to a continued worsening of cervical cancer trends.

Cervical cancer is preventable

The CDC says up to 93% of cervical cancers are preventable. HPV vaccination helps prevent infection with the HPV types that cause most cervical cancers. When paired with Pap and HPV tests, we have a powerful one-two punch against this disease.

The CDC recommends that girls and boys between ages 11 and 12 be given the HPV vaccine, and it can be given as early as age 9.

Vaccinating boys can help prevent them from getting infected with the types of HPV associated with cervical cancer and help protect girls from the virus by possibly decreasing transmission.

It's very important that women discuss cervical cancer prevention with their healthcare professionals. Doctors and nurses can help women and young people understand what screening tests are best for them and when they should get screened.

Thanks to modern medicine, the CDC can make this bold claim: "No woman should die of cervical cancer.”