Cervical Cancer Facts and Stats

Cervical cancer forms in the tissues of the cervix (the lower part of the uterus). It usually develops slowly, beginning with precancerous abnormalities that gradually turn into cancer. Since early symptoms are uncommon, regular Pap tests are essential for detecting these abnormalities before they become cancerous. Most invasive cervical cancers are found in women who have never been screened or have not had a Pap test within the past 5 years.

Key Statistics:

• In 2010, an estimated 12,200 new cases of invasive cervical cancer were diagnosed in U.S. women.
     
• In 2010, an estimated 4,210 U.S. women died from the disease. 

• Most women with cervical cancer are diagnosed before the age of 50; however, older women remain at risk. Almost 20% of new cases are diagnosed in women over 65. Cervical cancer in women younger than 20 is relatively rare. 
   
• In the U.S., Hispanic women have more than twice the rate of cervical cancer compared to non-Hispanic white women. African-American women develop cervical cancer about 50% more often than non-Hispanic white women.
     
• Between 1955 and 1992, the rate of cervical cancer deaths in the U.S. dropped by 74%. The main reason was the increased use of screening with Pap tests. The death rate continues to decline by nearly 3% a year.
   
• When detected at its earliest stage, cervical cancer has a 5-year relative survival rate of approximately 91%. For regional disease, it is nearly 58%. If the cancer has spread to distant organs, 5-year survival drops to under 20%. In general, the prognosis is affected by the extent of disease at the time of diagnosis.

• As of January 2007, there were approximately 250,000 cervical cancer survivors living in the U.S. according to the National Cancer Institute.

Risk Factors:   

• Human papilomavirus (HPV): HPV is a group of over 100 related viruses. Infection by certain high-risk types of HPV (such as HPV 16, 18, 31, 33, 45, as well as others) is the most important risk factor for cervical cancer. Nearly all cervical cancers are caused by HPV.

• Sexual history: Sexual activity at an early age, multiple sexual partners, and/or sex with uncircumcised males increase a woman's risk for cervical cancer because of an increased risk for HPV infection.

• Chlamydia infection: Some studies have found a higher risk of cervical cancer in women with past or current chlamydia infections.

• Weakened immune system : A weakened immune system places women at higher risk for HPV infections and also for cervical cancer.

• Smoking: The risk of cervical cancer is nearly doubled for women who smoke. Smoking not only exposes the body to cancer-causing chemicals but also weakens the immune system.

• Multiple full-term pregnancies: Women with 3 or more full-term pregnancies have an increased risk of developing cervical cancer. Studies have pointed to hormonal changes or weaker immune systems during pregnancy as possibly allowing for HPV infection and cancer growth.

• First full-term pregnancy at a young age: A first full-term pregnancy in women younger than 17 years old nearly doubles the risk of developing cervical cancer later in life, as compared with women who had their first full-term pregnancy at 25 years and older.

• Oral contraceptives: The long-term use of oral contraceptives slightly increases the risk of developing cervical cancer. Research suggests that the risk decreases after stopping.

• Diet and weight: Some studies have shown that diets low in fruits and vegetables, as well as being overweight, may place women at increased risk for developing cervical cancer.

• Diethylstilbestrol (DES): DES may increase the risk of a rare form of cervical cancer in women whose mothers took DES when pregnant. There is about 1 case of this type of cancer in every 1,000 DES daughter. (DES was given to some pregnant women in the United States from 1940 to 1971.)

• Family history of cervical cancer: A women with a mother or sister with cervical cancer has 2 to 3 times the risk of women without this family history. Possible explanations range from inherited tendencies that may make persistent HPV infection more likely, or to an increased probability of having one or more of the other non-genetic risk factors.

Risk Reduction:     

• Women have a choice between two FDA-approved vaccines (brand names, Gardasil and Cervarix). The approved vaccines protect against infection by HPV types 16 and 18.

• Vaccination is not a substitute for screening with Pap tests. Even in women who have been vaccinated, cervical cancer is still possible. Nearly all cervical cancer can be prevented with routine Pap tests and by limiting exposure to risk factors.

Screening Guidelines

There are minor differences in the screening guidelines of U.S. professional societies for women with average risk. Listed below are the recommendations of the American Cancer Society. Following the list is a comparison table of ACS recommendations with those of the American College of Obstetricians and Gynecologists (ACOG).

• All women should begin cervical cancer screening (Pap tests) about 3 years after they start having sex, but no later than age 21. A Pap test should be done every year (if conventional cytology) or every 2 years (if liquid-based cytology).
   
• Beginning at age 30, women at average risk with 3 or more normal Pap tests in a row may choose to be screened every 2 to 3 years. (Women at increased risk should continue annual screening.) 
   
• Another option for women who are 30 and older is screening every 3 years with either type of Pap test (conventional or liquid-based cytology) plus HPV DNA testing. 
   
• Beginning at age 70, women with 3 or more normal Pap tests in a row, plus no abnormal Pap tests within the last 10 years, may choose to stop getting screened. (Women with a history of cervical cancer, or with other certain risk factors, should continue getting screened for as long as they are in good health.) 
   
• Women who have had a total hysterectomy for reasons other than cervical cancer or precancer may also choose to stop getting screened. Women who have had a simple hysterectomy should continue getting screened as described above.

References:

American Cancer Society (ACS). (2010). Cancer facts & figures 2010. Accessed Feb. 25, 2011, from http://www.cancer.org/research/cancerfactsfigures/cancerfactsfigures/cancer-facts-and-figures-2010

American Cancer Society (ACS). (2010). Cervical cancer: detailed guide. Accessed Mar. 1, 2011, from http://www.cancer.org/Cancer/CervicalCancer/DetailedGuide/index

American Cancer Society (ACS). (2010). Cervical cancer: overview guide. Accessed May 24, 2011, from http://www.cancer.org/Cancer/CervicalCancer/OverviewGuide/index

National Cancer Institute (NCI). (2009). What you need to know about cervical cancer. Accessed Mar. 6, 2011, from
http://www.cancer.gov/cancertopics/wyntk/cervix

National Guideline Clearinghouse (NGC).Guideline summary:Cervical cytology screening. American College of Obstetricians and Gynecologists (ACOG). Accessed Mar. 6, 2011, from
http://www.guideline.gov/content.aspx?id=15274

Surveillance Epidemiological and End Results (SEER), National Cancer Institute (NCI). (2009). SEER Stat Fact Sheets: Cervix Uteri. Accessed May 24, 2011, from http://seer.cancer.gov/statfacts/html/cervix.html

For additional information on cervical cancer screening and diagnosis, please visit:

• Cervical Cancer Detailed Guide (American Cancer Society)
• What You Need to Know About Cervical Cancer (National Cancer Institute)
• Cervical cancer information, publications, educational materials (Gynecologic Cancer Foundation)

For information on cancer screening services for medically underserved women:

Breast and cervical cancer screening services are available to medically underserved women living in the United States through the National Breast and Cervical Cancer Early Detection Program (NBCCEDP). The program is sponsored by the Centers for Disease Control and Prevention (CDC) and provides access to free or low-cost screening for eligible women.

For women in California, the California Department of Public Health (CDPH) Cancer Detection Section (CDS) provides clinical breast exams, mammograms, pelvic exams and Pap tests to California's underserved women through the Cancer Detection Programs: Every Woman Counts (CDP: EWC). The program is funded by a federal grant and state tobacco tax revenue. 

Women who would like to find out if they qualify for the program may call 1-800-511-2300 Monday - Friday, from 8:30 AM to 5 PM. The CDP: EWC representative for your area may know of other low-cost screening programs that might be available to you. Regional Contractors are also your link to support groups, advocacy groups and the latest information on what's happening in your community.

Updated: May, 2011

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