The incidence of distant-stage cervical cancer in the United States increased by 1.3% per year from 2001 to 2018, according to data published in the International Journal of Gynecologic Cancer.

The data also showed that Black patients had the highest incidence of distant-stage cervical cancer, but White patients had the greatest annual increase in distant-stage cervical cancer. 

Researchers explored the incidence of stage IV cervical cancer, and factors linked with such incidence, using data from the US Cancer Statistics program. 

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A total of 29,715 patients were diagnosed with distant-stage disease from 2001 to 2018. 

Black and Hispanic patients were more likely to be diagnosed with distant-stage cervical cancer than were White and Asian patients. The age-adjusted incidence was 1.55, 1.01, 0.92, and 0.67 cases per 100,000 individuals, respectively (P <.001). 

The incidence of distant-stage cervical cancer increased over time for most racial/ethnic groups. The average annual percent change (AAPC) was 1.30% overall, 1.67% in White patients, 0.61% in Black patients, 0.22% in Asian patients, and -1.06% in Hispanic patients.

The researchers also found that HPV vaccination and non-guideline Pap screening increased over time for all groups analyzed.

The AAPC of non-guideline Pap screening was 7.0% overall, 8.2% in Black patients, 7.1% in White patients, and 5.8% in Hispanic patients. Data were not available for Asian patients. 

Among patients aged 13 to 17 years, the AAPC of vaccination against HPV was 6.6% overall, 6.9% in Black patients, 6.3% in White patients, and 5.9% in both Hispanic and Asian patients.

“This study demonstrates that, in spite of cervical cancer screening and HPV vaccination uptake in the USA, there still exist significant racial and ethnic disparities in distant-stage cervical cancer,” the researchers wrote. “While this is well known in the literature, this study also found that there is an increase in the rate of distant-stage cervical cancer, largely due to the increase in rate of distant-stage adenocarcinoma in younger White women.”


Francoeur AA, Liao CI, Casear MA, et al. The increasing incidence of stage IV cervical cancer in the USA: what factors are related? Int J Gynecol Cancer. Published online August 18, 2022. doi:10.1136/ijgc-2022-003728