Eliminating cervical cancer is possible.
The goal is years away and varies widely by state, according to a new paper by researchers at MUSC Hollings Cancer Center, said lead author Trisha Amboree, Ph.D. The paper was published in JNCI Cancer Spectrum.
Amboree worked with colleagues at Hollings, MD Anderson Cancer Center and the University of Puerto Rico Comprehensive Cancer Center to quantify how close each state, Puerto Rico and the District of Columbia are to reaching elimination.
In public health terms, elimination doesn’t mean zero but rather four cases or fewer per 100,000 women.
Unlike many other cancers, it’s possible to set an elimination goal because cervical cancer is largely preventable. Nearly all cases are caused by the human papillomavirus (HPV), for which a safe and effective vaccine exists. In addition, screening can catch pre-cancers and early cancers, and timely treatment leads to five-year survival rates of greater than 90% for early-stage cancers.
However, only one state, Massachusetts, is close to the elimination goal.
Massachusetts’ cervical cancer incidence rate indicates it is almost there, at 4.3 cases per 100,000 in recent years.
“Most other states are still pretty far off, particularly in the Southeast and Southwest regions,” Amboree said.
Both of these regions have more than double the rate of cases than the elimination target. The Southwest is at 11.2 cases per 100,000, and the Southeast at 9.9 cases per 100,000, according to recent data.
South Carolina had 8.9 cases per 100,000. The state with the highest incidence rate was Mississippi, with 14.8 cases per 100,000.
Elimination can seem like a far-off idea, to get to fewer than four cases per 100,000 women, but it is indeed doable if we can implement these plans properly and see more people be vaccinated, screened and treated as needed. We can reach elimination.
Mortality rates from cervical cancer also show stark differences between the states, with the highest mortality rates occurring in the Southwest and Southeast regions while the lowest mortality rates were in the Northeast.
Unfortunately, despite a slight nationwide decrease in cervical cancer incidence and mortality, many individual states aren’t showing progress.
The researchers compared incidence rates between the time period of 2007-2011 and the time period of 2017-2021 to determine if rates declined over that decade.
“For the most part, we didn’t find any pronounced changes in the right direction. Our rates are pretty stagnant when comparing the baseline period to the most recent five-year period,” Amboree said.
Despite the numbers, Amboree is hopeful that improvements can be made once people realize that cervical cancer elimination is possible.
“If we can really bring together the three pillars of elimination, which are improving HPV vaccination, increasing screening and improving timely treatment of pre-cancers and cervical disease, then not only will we begin to see incidence of advanced disease decrease, but we'll also see mortality significantly decrease in the future,” Amboree said.
Amboree is actively involved with the HPV Vaccination Roundtable of the Southeast, which has developed toolkits for public health leaders to use to improve prevention efforts across the region.
“Elimination can seem like a far-off idea, to get to fewer than four cases per 100,000 women, but it is indeed doable if we can implement these plans properly and see more people be vaccinated, screened and treated as needed,” Amboree said. “We can reach elimination.”
References
This research was supported through grants from the American Cancer Society Institutional Research Grant (#IRG-24-1290553-23-IRG, PI: Amboree), the National Cancer Institute (R01CA282424, MPI: Deshmukh, Ortiz), the National Library of Medicine (G08LM014413, PI: Sonawane), through the Hollings Cancer Center Support Grant (P30CA138313), and the MD Anderson Cancer Center Support Grant (P30CA016672).
Trisha L Amboree, Poria Dorali, Haluk Damgacioglu, Jane R Montealegre, Marvella E Ford, Brian Orr, Gweneth Lazenby, Britton Gibson, Ana Patricia Ortiz, Tonatiuh Suárez Ramos, Kalyani Sonawane, Ashish A Deshmukh, The cervical cancer divide: State variation in incidence, mortality, and progress toward elimination in the US, JNCI Cancer Spectrum, 2026;, pkag005, https://doi.org/10.1093/jncics/pkag005
Leslie Cantu
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