Don't Forget Your Pap: Advanced Stage Cervical Cancer Rates Are on the Rise

A new study in the International Journal of Gynecological Cancer shows an alarming increase in advanced-stage cervical cancer in Black and white women. While early-stage cervical cancer numbers are declining and preventative measures are available, researchers say that a growing group of women are forgoing regular checkups, which may lead to an increasing amount of late-stage detections.

What is cervical cancer?

Cervical cancer is a cancer of the cervix that is very slow-growing and progresses through a series of precancerous stages, often taking 3-7 years before becoming full-blown cancer. Cervical cancer is caused by an HPV (human papillomavirus) infection. HPV is an extremely common sexually transmitted disease that many people will get at one point in their life. The science isn’t clear as to why some women develop cervical cancer from HPV and some don’t.

Who’s most at risk?

Researchers looked at data on 29,715 women from 2001 to 2018. While BIPOC women are at a higher risk of developing cervical cancer, the sharpest increase in advanced stage cervical cancers was in White women at a rate of 1.69 percent, especially in the South among White women 40 to 44, who had the highest rise at an increase of 4.5 percent annually. Rates also increased among Black women at 0.67 percent annually.

Why are cases on the rise?

In an interview with CNN Mark Einstein, MD, explains that the likely culprit for the increase in cases is a lack of adherence to screening and vaccination guidelines.

“We know that cervical cancer in today’s day and age, with primary prevention with vaccination and secondary prevention with pap-based or HPV-based testing, will essentially eliminate cervical cancer, we have the tools right now to eliminate cervical cancer,” Einstein said.“But, what this data has shown is that when we’re not following those screening guidelines, or people aren’t getting screened enough, or people aren’t getting vaccinations, that we’re going to actually miss some of these windows of opportunity to pick up these cancers.”

The largest and fastest increases in metastatic cervical cancer were seen in the 30- to 34-year-old age group. Researchers added that people in this group are generally healthy and might forego health insurance if they don’t get it through an employer. Without insurance, women are less likely to come in for their annual pap smear, which can help detect cervical cancer in the early stages.

What can I do to prevent cervical cancer?

The Centers for Disease Control (CDC) recommends the HPV vaccine for routine vaccination at age 11 or 12 years. If not already vaccinated, the CDC recommends vaccination up to age 25. If you are older than 25 and still haven’t been vaccinated, the CDC doesn’t recommend you get it as it provides less benefit at this age, and many have already been exposed.

Regardless of your vaccination status, The American College of Obstetricians and Gynecologists recommends that women 21-29 should have a Pap test alone every 3 years. HPV testing alone can be considered for women who are 25 to 29, but Pap tests are preferred. Women who are 30 to 65 have three options for testing. They can have a Pap test and an HPV test (co-testing) every 5 years. They can have a Pap test alone every 3 years. Or they can have HPV testing alone every 5 years.

Screening is the most important key to preventing cervical cancer. Over the past 30 years in the United States, the number of cases of cervical cancer and deaths has decreased by half—mainly due to women getting regular cervical cancer screenings.

Is baby at risk?

“Full-blown cervical cancer during pregnancy is very uncommon,” says Sharon Phelan, MD, a professor of obstetrics and gynecology at the University of New Mexico. If you do develop cervical cancer during pregnancy, the cancer itself will not harm baby, but the treatments for cancer may. For this reason, doctors often recommend waiting to treat mild cases of cervical cancer until the baby is delivered.

For more information about cervical cancer during pregnancy, check out this Q&A with Phelan.

Please note: The Bump and the materials and information it contains are not intended to, and do not constitute, medical or other health advice or diagnosis and should not be used as such. You should always consult with a qualified physician or health professional about your specific circumstances.