ASPO Abstracts
Recent patterns in cervical cancer mortality in the United States: 2013-2019
Category: Cancer Health Disparities
Conference Year: 2023
Abstract Body:
Purpose: A recent US study (Shahmoradi et al. JAMA [published: November 21st, 2022]) showed a dramatic 2.5% per year rise in cervical cancer incidence among US women aged 30-34 years and plateauing of incidence among 35-54-year-old women beginning since 2013. The purpose of this study was to estimate incidence- based mortality trends for cervical cancer based on age at cancer diagnosis to clarify whether the increase is real or attributed to increased diagnostic scrutiny. Methods: We used data from the Surveillance Epidemiology End Results (SEER)-17 registries. To evaluate incidence-based (i.e., specific to histology and age at diagnosis) mortality overall and for 30-34-year-old women, we used the incidence-based mortality file that links the SEER-17 cancer incidence file with death certificate information. We identified cervical cancer cases using the International Classification of Diseases for Oncology codes (C53.0 to C53.9) and histology codes (8010 to 8671 and 8940 to 8941). To prevent underestimation of incidence-based mortality rates, we considered diagnoses during 2000-2019 and deaths during 2013–2019. We also estimated observed cervical cancer mortality trends (i.e., according to age at death). Analysis was conducted using SEER*Stat and Joinpoint Regression software. Results: Overall, the incidence-based mortality rate remained stable from 2013 to 2019 (APC 0.0%; 95% CI, -1.1% to 1.1%). However, when stratified by age at diagnosis, APC of 2.5% per year (95% CI, -1.4% to 6.5%) was observed for incidence-based mortality for age at cancer diagnosis at 30-34 years. Overall, the observed cervical cancer mortality rate declined significantly per year (APC, -1.2%; 95% CI -1.6% to -0.8%). The observed APC for cervical cancer mortality for age at death at 30- 34 was 1.0% (95% CI -3.9, 6.2). Conclusions: The positive annual percentage in incidence-based mortality for 30-34-year-old women that we observed provides supportive evidence to Shahmoradi et al suggesting that the rise in cervical cancer incidence in the US is likely real and not attributable to increased/improved screening. Future research is needed to understand the underlying reasons for the rise in cervical cancer incidence-based mortality rates in the US.
Keywords: cervical cancer; mortality