Cervical cancer incidence in a prevaccine era in the United States, 1998-2002.
OBJECTIVE
To report the incidence of cervical cancer by geography, race or ethnicity, and histology.


METHODS
We examined combined data from the National Program of Cancer Registries and the Surveillance, Epidemiology, and End Results Program covering 87% of the U.S. population. We calculated the age-adjusted incidence of cervical cancer by age, race or ethnicity, histology, and stage by region or state.


RESULTS
Rates of invasive cancer per 100,000 females declined from 10.2 in 1998 to 8.5 in 2002. Incidence rates by state ranged from 6.6 to 12.3 per 100,000. Rates were especially high among Hispanic women aged 40 years or older (26.5 or more) and African-American women aged older than 50 years (23.5 or more). Rates of squamous cell carcinoma were significantly higher among African-American and Hispanic women than among their white counterparts. In contrast, rates of adenocarcinoma (18% of all cases) were significantly lower among African-American women than in white women (rate ratio 0.88, P<.05). Rates of adenocarcinoma were significantly higher among Hispanic women than among non-Hispanics (rate ratio 1.71, P<.05). Although no regional differences were noted for adenocarcinoma, rates of squamous cell carcinoma were higher in the South than in other regions.


CONCLUSIONS
Despite intense screening in the past decade, higher rates of cervical cancer persist among women in the South and women who are African American or Hispanic. This information could guide more focused interventions to increase access to screening with cervical cytology as well as vaccination against human papillomavirus.


METHODS
III.
Saraiya
Mona
M
Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, 4770 Buford Highway, Atlanta, GA 30341, USA. msaraiya@cdc.gov
Ahmed
Faruque
F
Krishnan
Sheila
S
Richards
Thomas B
TB
Unger
Elizabeth R
ER
Lawson
Herschel W
HW
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D002277:Carcinoma / Q000208:ethnology* / Q000473:pathology; D002648:Child; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D007223:Infant; D008875:Middle Aged; D044468:Native Hawaiian or Pacific Islander / Q000706:statistics & numerical data; D009361:Neoplasm Invasiveness; D018426:SEER Program; D014481:United States / Q000453:epidemiology; D002583:Uterine Cervical Neoplasms / Q000208:ethnology* / Q000473:pathology; D044465:White People / Q000706:statistics & numerical data