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A new study finds that cases of late-stage cervical cancer are on the rise in the U.S., and some researchers suggest that a decline in screening among young women may be the reason more women are being diagnosed with the deadly disease.
While the overall incidence of cervical cancer in the U.S. is declining, the number of women suffering from advanced-stage disease — which has a five-year survival rate of 17 percent — is increasing.
Researchers from UCLA’s Department of Obstetrics and Gynecology set out to examine trends in stage 4 cervical cancer across the country by analyzing data from 2001 to 2018. In a study published Thursday in International Journal of Gynecologic Cancer, they found an increase of 1.3% per year in advanced disease, with the largest increase occurring among white women in the South aged 40 to 44, among whom cases increased by 4.5% per year.
The researchers also found that black women had an overall higher rate of late-stage cervical cancer — 1.55 per 100,000, versus 0.92 per 100,000 for white women.
Dr. Alex Francoeur, a fourth-year obstetrician-gynecologist at UCLA, said the team’s recent study was born out of a study published last year that found a 3.39 percent annual increase in advanced cases among women ages 30 to 34. .
“This is a disease where only 17 percent of patients will be alive after five years,” Francoeur said. “So if you’re a 30-year-old who’s not going to see his 35th birthday, that’s tragic.”
The Centers for Disease Control and Prevention recommends that women start getting Pap tests at age 21 and follow up every three years, depending on their health history. The test shows pre-cancerous conditions that, if found, can be surgically removed. Cervical cancer, detected early enough, can have a five-year survival rate of over 90%.
Women should also get routine human papillomavirus (HPV) testing, according to National Cancer Institute guidelines. The virus is linked to more than 90% of all cancers of the anus and cervix, as well as a high percentage of other cancers.
Francoeur said she suspects many women put off routine tests because they don’t have obvious health problems. But HPV is the most common sexually transmitted disease, according to the CDC, so common that most sexually active people will contract the virus at some point in their lives.
Another concern is that the most recent data is from 2018, Francoeur said, which does not include the COVID-19 pandemic, during which routine health care for many was put on hold.
“I’m concerned that in the last two years, people have had a lot of barriers to accessing health care,” she said. “I think we may see this trend get a little worse before it gets better.”
Francoeur recommended that “even if you’re in your late 20s and early 30s and don’t have any medical problems, you need a primary care physician because routine health screenings save lives.”