Changing demographics of cervical cancer in the United States (1973-2008)

Objective

To describe changes in the cervical cancer population.

Methods

The SEER database 9 registries from 1973 to 2008 were queried to perform a retrospective cohort study of women with invasive cervical cancer. Estimated annual percent change (EAPC) in incidence rates and 95% confidence intervals (CI) over the entire study period were compared according to age, stage, race, and cell type (squamous [SCC] and adenocarcinoma [ACA]). Proportions and odds ratios (OR) were calculated for patients diagnosed during the second half (1990-2008) compared to first half (1973-89) of the study period.

Results

40,363 women with cervical cancer were entered into SEER. The EAPC are falling fastest among those with localized disease (− 2.5%; 95% CI − 2.8 to − 2.1), age ≥ 50 (− 3.0%; 95% CI = − 3.2 to − 2.8), and black women (− 3.8%; 95% CI = − 4.1 to − 3.6). The odds of a newly diagnosed cervical cancer patient having advanced disease are 10% higher, being less than age 50 are 37% higher, and being Asian or Pacific Islander are 68% higher in the second time period as compared to the first.

Conclusions

In the US, the population with cervical cancer is changing. Patients are presently significantly more likely to be pre-menopausal, Asian or Pacific Islander, and more frequently have non-squamous histology than previously. These progressive and cumulative changes could be due to the disparate impact of current population based screening and prevention strategies. Understanding the implications of these evolving population characteristics may facilitate planning targeted studies and interventions for cervical cancer prevention, screening and treatment in the future.