Trends in cervical cancer incidence rates among demographic groups: A SEER database analysis.

Abstract

e17524 Background: Cervical cancer (CC) is the fourth most common cancer in women worldwide, with most cases caused by human papillomavirus (HPV) infection. The incidence of CC has decreased since the mid-1900s due to effective cytological screening, treatment of precancerous lesions, and vaccinations against HPV. Nonetheless, over ten thousand women in the US are diagnosed with CC yearly. Up-to-date data on the trends in cervical cancer incidence rates (IR) among different racial and age groups is lacking. Here we present an in-depth analysis of these IR trends between 1975-2018. Methods: The National Cancer Institute SEER 9 database was used to generate CC IR from 1975 to 2018 as they relate to age, race, histopathology, and county classification. Joinpoint modeling was used to incidence trends and annual percent changes (APC) with 95% confidence intervals (CI) using Monte Carlo permutation analysis to generate best-fit models with a 2-tailed t-test (p<0.05). Patients with CC were identified using ICD-O-3 primary site codes. Results: Overall, age-adjusted primary CC IR declined significantly between 1975 and 2018. Black individuals had the highest IR throughout the study period. When compared to the other racial groups, Black experienced a steeper decline in IR between 1975 and 2018. By 2018, the disparity in IR between Black individuals and White/Other individuals had nearly vanished. Of the two histopathologies studied, squamous cell carcinoma IR declined, while the IR of adenocarcinoma increased slightly. Among age groups, the IR among individuals aged 50-64 and 65+ decreased most dramatically over time. The two groups had the highest IR in 1975, but by 2018 the IR in both age groups had dropped below that of individuals aged 35-49 years. Patients in urban counties experienced similar IR decreases to those in urban and rural areas. Conclusions: Although screening and HPV vaccination initiatives have been successful at decreasing IR of CC, disparities in IR trends among racial and demographic groups persist. Examining age, racial, and community-specific CC IR trends at the population level will help prioritize resource allocation to reduce CC IR in all groups and minimize the existing gap. [Table: see text]