Study: Death Rate from Cervical Cancer Higher Than Thought

older woman is comforting by a man

The death rate from cervical cancer in the US is higher than previously thought, especially among African-American women and older women, according to a study by researchers at Johns Hopkins University. The study was published January 23 in Cancer, a peer-reviewed journal of the American Cancer Society.

The researchers found that black women in the US are dying from cervical cancer at a rate 77% higher than previously thought, and white women are dying at a rate 47% higher than previously thought. They arrived at the new numbers by excluding women who have had hysterectomies, which typically involve removal of the cervix – thereby eliminating the risk of getting cervical cancer. They say their data provide a more accurate view of who is getting cervical cancer, which will help efforts to prevent it.

The researchers also found the disparity between black and white women increases with age. Black women age 85 and older had the highest death rate using the new calculation.

In 2017, an estimated 12,820 new cervical cancer cases are expected to be diagnosed in the US and an estimated 4,210 women are expected to die from it.

A clearer picture of disparity

The researchers got their data from the National Center for Health Statistics and from the Surveillance, Epidemiology, and End Results (SEER) national cancer registries. They looked at the rates of death from cervical cancer, and then recalculated the rates after removing those who had had a hysterectomy from the database numbers. Excluding these women makes a big difference because as many as 1 in 5 women has had a hysterectomy, according to the study. Black women are more likely than white women to have had hysterectomies, and at younger ages, in large part because they are more susceptible to fibroid tumors, which can lead to the surgery.

The study’s calculations show that black women in the US who have not had a hysterectomy are about as likely to die from cervical cancer as women in underdeveloped countries of sub-Saharan Africa.

The study was not designed to uncover the reasons for the disparities, although previous research suggests that black women are more likely than white women to have their cervical cancer caught at a later stage of diagnosis and may be more likely to receive radiation and less likely to receive surgery as part of their treatment. The study authors say future research should focus on investigating and overcoming factors that contribute to differences in death rates.

"While trends over time show that the racial disparities gap has been closing somewhat, these data emphasize that it should remain a priority area," said Anne F. Rositch, PhD, MSPH. "Black women are dying of cervical cancer at twice the rate as white women in the United States and we need to put in place measures to reverse the trend."

Most cervical cancers can be prevented or found early

Virtually all cervical cancers are caused by infection with certain types of the human papilloma virus (HPV). Following the American Cancer Society guidelines can help find cervical cancer early, and can also find pre-cancers, which can be treated to keep cervical cancer from forming.

  • All women should begin cervical cancer screening at age 21.
  • Women between the ages of 21 and 29 should have a Pap test every 3 years. They should not be tested for HPV unless it is needed after an abnormal Pap test result.
  • Women between the ages of 30 and 65 should have both a Pap test and an HPV test every 5 years. This is the preferred approach, but it is also OK to have a Pap test alone every 3 years.
  •  Women over age 65 who have had regular screenings with normal results should not be screened for cervical cancer. Women who have been diagnosed with cervical cancer or pre-cancer should continue to be screened according to the recommendations of their doctor.
  • Women who have had their uterus and cervix removed in a hysterectomy and have no history of cervical cancer or pre-cancer should not be screened.
  • Women who have had the HPV vaccine should still follow the screening recommendations for their age group.
  • Women who are at high risk for cervical cancer may need to be screened more often. Women at high risk might include those with HIV infection, organ transplant, or exposure to the drug DES. They should talk with their doctor or nurse.

Another way of preventing cervical cancer is to get vaccinated against HPV. But to get the most out of the HPV vaccine, it should be given at an early age. The American Cancer Society recommends that the vaccine series be started at age 11 or 12, although it can be given to girls and women up to age 26.

The American Cancer Society medical and editorial content team
Our team is made up of doctors and master's-prepared nurses with deep knowledge of cancer care as well as journalists, editors, and translators with extensive experience in medical writing.

Hysterectomy-corrected cervical cancer mortality rates reveal a larger racial disparity in the United States. Published January 23, 2017 in Cancer. First author Anna L. Beavis MD, MPH, Johns Hopkins Medicine, Baltimore.


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