MedicalResearch.com Interview with:
Farhad Islami, MD PhD
Scientific Director, Surveillance Research
American Cancer Society, Inc.
Atlanta, GA 30303
MedicalResearch.com: What is the background for this study?
Response: Despite a continuous decline in cervical cancer incidence rates, earlier studies reported an increase in cervical adenocarcinoma incidence rates. However, those reports had major limitations, as they did not account for changes in hysterectomy prevalence and used cancer occurrence data covering only 10%-12% of the U.S. population (which may not be representative of the entire population, especially racial/ethnic minorities).
Further, the most recent study examined the trends by age and histology through 2010. We examined contemporary trends in cervical cancer incidence rates in the U.S. (1999-2015) by age, race/ethnicity, major histological subtypes, and stage at diagnosis using up-to-date nationwide data after accounting for hysterectomy prevalence.
MedicalResearch.com: What are the main findings?
Response: Overall incidence rates of histologically confirmed cervical squamous cell cancer (SCC) decreased during 1999-2015 in almost all race/ethnicities and all age groups. During the most recent years (2011-2015), however, overall cervical SCC incidence rate was stable among non-Hispanic whites (largely driven by stable trends in ages <50 years), and rates stabilized or the pace of declines slowed in some age groups among Hispanics.
Among non-Hispanic white women, the overall incidence rate of histologically confirmed cervical adenocarcinoma increased during 2002-2015 (1.3% annually), largely confined to ages 40-49 years (4.4% annually during 2004-2015) and 50-59 years (5.5% annually during 2011-2015). Among black women, after a decline in cervical adenocarcinoma rates during 1999-2015 (1.9% annually), rates stabilized in more recent years. Overall rates continued to decrease in Hispanics (0.9% annually) and remained stable in Asian/PIs throughout 1999-2015. By age group, trends were generally stable in ages <50 years and declined in older age groups among blacks, Hispanics, and Asian/PIs throughout 1999-2015. We also found increases in incidence rates of distant stage cervical SCC and adenocarcinoma in several age groups among non-Hispanic white women.
MedicalResearch.com: What should readers take away from your report?
Response: More research on natural history of cervical cancer, HPV carcinogenicity, and relevant biomarkers is required to improve screening strategies (e.g., identify optimal intervals, reduce overdiagnosis). More implementation research is also needed to accelerate the delivery and utilization of cervical cancer screening and HPV vaccination according to guidelines.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: Our findings have significant public health implications in view of the opportunity to reduce premature morbidity and mortality and societal cost associated with the disease, particularly in young women when they are in the workforce and supporting their families.
Conflict of Interest Disclosures: The authors report being employed by the American Cancer Society, which received a grant from Merck Inc. for intramural research outside the submitted work; however, their salary is solely funded through the American Cancer Society. No other disclosures were reported by the authors of this paper.
Trends in cervical cancer incidence rates by age, race/ethnicity, histological subtype, and stage at diagnosis in the United States
lFarhadIslami, Stacey A.Fedewa, AhmedinJemal
Available online 16 April 2019
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