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J Glob Oncol. 2016 Oct;2(5):275-283. doi: 10.1200/JGO.2015.001677.

Prioritizing US Cervical Cancer Prevention With Results From a Geospatial Model.

Author information

National Cancer Institute, Rockville.
Information Management Services, Silver Spring, MD.
Centers for Disease Control and Prevention, Atlanta, GA.



To determine if differences in screening and vaccination patterns across the population may accentuate ethnic and geographic variation in future burden of disease.


Using Cancer in North America data provided by the North American Association of Central Cancer Registries, county cervical cancer incidence trends from 1995 to 2009 were modeled for the entire United States using ecologic covariates. Rates for health service areas were also modeled by ethnicity. State-level incidence was mapped together with Papanicolaou (Pap) screening, past 3 years (women ≥ 18 years old), and three-dose human papillomavirus (HPV) vaccine coverage (girls 13 to 17 years old) to identify potential priority areas for preventive services.


US cervical cancer incidence decreased more during the periods 1995 to 1999 and 2000 to 2004 than during the period 2005 to 2009. During these 15 years, the most affected areas became increasingly confined to Appalachia, the lower Mississippi Valley, the Deep South, Texas, and Florida. Hispanic and black women experienced a higher incidence of cervical cancer than both white and Asian and Pacific Islander women during each period. Women in 10 of 17 states/districts with a high incidence (≥ 8.14/100,000) reported low Pap testing (< 78.5%), HPV vaccine coverage (< 33.9%), or both prevention technologies.


The decline in cervical cancer incidence has slowed in recent years. Access to HPV vaccination, targeted screening, and treatment in affected populations is needed to reduce cervical cancer disparities in the future.

Conflict of interest statement

AUTHORS’ DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST The following represents disclosure information provided by authors of this manuscript. All relationships are considered compensated. Relationships are self-held unless noted. I = Immediate Family Member, Inst = My Institution. Relationships may not relate to the subject matter of this manuscript. For more information about ASCO’s conflict of interest policy, please refer to or Jonathan K. Kish Employment: Cardinal Health Consulting or Advisory Role: Cardinal Health (Inst) Travel, Accommodations, Expenses: Cardinal Health Alicia I. Rolin No relationship to disclose Zhaohui Zou No relationship to disclose James E. Cucinelli No relationship to disclose Zaria Tatalovich No relationship to disclose Mona Saraiya No relationship to disclose Sean F. Altekruse No relationship to disclose

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