Summary: The number of women stricken by cancer of the cervix is steadily decreasing. Overall rates of US women diagnosed with invasive cervical cancer declined 17% between 1998 and 2002, though higher rates exist for Hispanic and African-American women, and those who live in the South, according to a new study.

Why it's important: The research sheds light on racial, ethnic, and regional differences in cervical cancer rates. This information could help researchers figure out why there are differences in cancer rates between different groups of women. And it could help them design more effective strategies to lower those rates in populations at particularly high risk through cervical cancer education, screening, and other programs. The information also will be important in helping researchers track how well the recently approved vaccine against HPV (human papillomavirus) is working. HPV is the virus responsible for most cervical cancers; it is hoped that widespread use of the vaccine may eventually lower cervical cancer rates.

What's already known: The rates of women diagnosed with invasive cervical cancer declined substantially after 1955, mainly due to widespread use of the Pap test to find cervical cancer early. But this benefit has not been achieved evenly among all races, ethnicities, and regions of the country. The 2006 introduction of the HPV vaccine is expected to aid cervical cancer prevention efforts and continue to reduce incidence.

How this study was done: The research team looked at a national cancer database. The study included more than 59,800 women, and was led by researchers at the US Centers for Disease Control and Prevention in Atlanta and at other institutions. Their findings appear in Obstetrics & Gynecology , a journal of the American College of Obstetricians and Gynecologists.

What was found: The 17% drop in the number of cervical cancer cases is for the overall number of patients during the 4-year period. Unfortunately there is a much higher incidence of cervical cancer in Hispanic and African-American women compared to white women, the authors say. Also, there are higher rates of squamous cell carcinoma (the most common type of cervical cancer) in women who live in the South compared to all other US regions.

Bottom line: Although declining cancer incidence rates are welcome news, there is still room for improvement in cervical cancer. Reducing the differences in racial, ethnic and regional diagnosis can be accomplished with cancer education, prevention, and screening methods, the study authors say. Young women can delay starting to have sex until they are older. Other ways to reduce the risk of getting HPV include having fewer sexual partners and using condoms. Females under the age of 26 also should talk to their doctors about the new HPV vaccine, which offers protection against the HPV subtypes thought to cause 70% of cervical cancers.

Citation: "Cervical Cancer Incidence in a Prevaccine Era in the United States, 1998-2002." Published in the February issue of Obstetrics & Gynecology (Vol.109. No. 2, 360-370). First author: Mona Saraiya, MD, MPH, Centers for Disease Control and Prevention, Atlanta.