Cervical cancer rates rising in low-income U.S. counties

Study reveals staggering rise in cervical cancer incidence and mortality rates among women living in America’s lowest-income counties

Women in low-income areas of the U.S. face a stark rise in cervical cancer incidence and mortality, according to a new study led by researchers from The University of Texas MD Anderson Cancer Center. 

The results, published in the International Journal of Cancer, demonstrate that the incidence rate for distant-stage cervical cancer has increased most among white women living in low-income counties, at 4.4% annually since 2007. The largest increase in cervical cancer mortality rates occurred in Black women in low-income counties, at 2.9% annually since 2013, despite cancer incidence in this group declining.

“The findings are quite concerning,” said lead author Trisha Amboree, Ph.D., postdoctoral fellow in Behavioral Science. “Despite decades of improvement due to the widespread implementation of cervical cancer prevention programs in the U.S., our study shows women may be facing disruptions along the screening and treatment continuum that are leading to more distant-stage cancers and, potentially, more deaths.”

In 2019, cervical cancer incidence across all racial and ethnic groups was greater among women living in low-income counties in the U.S., with the highest absolute incidence observed among Hispanic women.

"These data add to a growing body of evidence indicating widening disparities driven by socioeconomic status,” said co-senior author Jane Montealegre, Ph.D., associate professor of Behavioral Science. “Cervical cancer is almost entirely preventable through vaccination against human papillomavirus (HPV), screening and early detection. This continued upward trend calls for scaled-up efforts to eliminate disparities in cervical cancer prevention.”

Researchers used Surveillance, Epidemiology, and End Results-22 (SEER-22) program data between 2000 and 2019 to examine occurrences of cervical cancer diagnoses and deaths. They also analyzed race, ethnicity and county-level median household income, which ranged from $19,330 to $38,820 in the low-income counties.

The study was done in collaboration with Ashish Deshmukh, Ph.D., co-leader of the Cancer Control research program at The Medical University of South Carolina Hollings Cancer Center and was supported through grants from the National Institute on Minority Health and Health Disparities (R01MD013715, K01MD016440, 3R01MD013715-04S1) and the National Cancer Institute (R01CA232888). A full list of collaborating authors and their disclosures can be found in the paper.