Cervical Cancer Incidence Is Rising—Especially Among White Women

Cervical cancer develops when cells in the cervix grow uncontrollably. Cervical cancer is one of the most common cancers among women worldwide and is particularly prevalent in Africa, Latin America and the Middle East. It usually occurs after age 45, and factors such as beginning sexual activity at an early age, having many sexual partners and HIV infection increase the risk.

HPV Causes More Than 95% of Cervical Cancers

HPV (Human Papilloma Virus) is the most commonly sexually transmitted virus and the leading cause of cervical cancer. HPV causes changes in cervical cells, and these changes can become cancerous over time.

Key facts about HPV and cervical cancer include the following:

• Most HPV infections are cleared by the body’s immune system and do not cause cervical cancer.
• About 0.8% of chronic cervical HPV infections become cancerous within 20-30 years.
• Around 40 types of HPV infect humans. Some can cause cervical cancer, so women exposed to the HPV types that cause cervical cancer have a higher risk.
• Types 16 and 18 are considered the highest-risk HPV types for cervical cancer. Types 31, 33, 45, 52 and 58 are also among those that can cause cervical cancer.
• This risk can therefore be reduced with HPV vaccines . There are 3 types of HPV vaccine: the 2-valent, 4-valent and 9-valent vaccines.
• Early diagnosis of cervical cancer is very important because this cancer is treatable. Women are therefore advised to undergo regular cervical cancer screening.
• These screening tests include Pap smear testing and HPV screening .
• A Pap smear examines a sample taken from the cervix. If abnormal cells are detected, further investigation is performed. HPV screening detects the presence of certain HPV types associated with cervical cancer.
• Cervical cancer screening and HPV vaccination are ways to protect against cervical cancer.
• Women should begin cervical cancer screening at age 25 and have an HPV test every 5 years until age 65. If HPV testing is unavailable, individuals aged 25 to 65 should be screened with co-testing (a smear together with an HPV test) every 5 years or a smear alone every 3 years.
• The HPV vaccine protects against HPV types associated with cervical cancer and is recommended for children aged 11-12 and adults under 26. The 9-valent vaccine can be given up to age 45.
• The 2-valent and 4-valent vaccines are available in Turkey; the 9-valent vaccine has not yet arrived.
• HPV vaccination has substantially reduced cervical cancer incidence, and the vaccines are highly effective. Australia, the country that has most successfully implemented population-wide HPV vaccination, is making steady progress toward eliminating cervical cancer.
• HPV does not only cause cervical cancer: it causes 6% of all cancers. In addition to cervical cancer, HPV can cause cancers of the anus, penis, pharynx, mouth, throat, vagina and breast.

Why Cervical Cancer Matters

According to World Health Organization (WHO) data, 70 percent of cervical cancer deaths in 2018 occurred in developing countries. WHO data also show that cervical cancer was the 7th most common cancer worldwide in 2020, with 604 thousand new cases, accounting for 3.1% of all new cancer cases. According to the 2020 Turkey Cancer Statistics, cervical cancer was the 18th most common cancer in Turkey, with 2,532 new cases annually. There were 1,245 deaths from this cancer that year.

Cervical Cancer Rates Are Rising Faster Among White Than Black Women in the US

Two independent studies showed that cervical cancer incidence is increasing faster among white women than among black women in the US. Because this finding was unexpected, researchers say it may point to problems in US healthcare that extend beyond women’s health.

Cervical cancer incidence (the annual rate of new cases) in the US has remained stable since 2010 and currently stands at 7.5 per 100 thousand people.

There are known differences in cervical cancer between white and black women. Compared with white women, black women are more likely to have stage 4 cancer (spread to distant tissues/organs) at diagnosis and to die from their cancer. However, two independent studies published in the past 5 months suggest that white women are developing cervical cancer at a rapidly increasing rate.

The first study found that cervical cancer rates among white women aged 30-34 were increasing by 2.8% annually, while remaining stable among black women. An analysis of the same database for 2001-2018 by UCLA (University of California Los Angeles) found that advanced cervical cancer, defined as spread to the bladder and/or rectum, increased by 1.69% annually among white women and 0.67% among black women.

Several studies have shown that cervical cancer is increasing faster among white women than among black women in the US. These findings surprised researchers, because black patients rarely fare better than white patients in cancer. There are theoretical explanations for these findings, including the possibility of inaccurate data. White women have also been shown not to meet cancer screening criteria and therefore to tend toward later diagnosis. This tendency among white women may also relate to social, political and healthcare system changes. These studies indicate a need to improve cervical cancer screening in the US and ensure equity in this area.

In conclusion, the leading cause of cervical cancer is a chronic infection caused by the sexually transmitted virus HPV. This cancer is one of the leading causes of death among women worldwide. HPV vaccines can reduce cervical cancers almost completely. However, vaccination rates are quite low except in a few countries. The COVID-19 pandemic has also disrupted cancer screening, which was already being performed at less-than-ideal rates. These factors are expected to increase cervical cancer incidence.