Income Affects Incidence, Outcomes for U.S. Patients With Cervical Cancer

Using data from the Surveillance, Epidemiology, and End Results Program, researchers investigated hysterectomy-corrected cervical cancer incidence and mortality trends in relation to patients’ county-level income, race and ethnicity, and stage at diagnosis. Since the American Medical Association first recommended (https://blogs.cdc.gov/cancer/2014/01/28/the-power-of-the-pap/#:~:text=The%20%E2%80%9CPap%E2%80%9D%20test%2C%20as,recommending%20Pap%20tests%20for%20women.) cytologic testing as a cervical cancer screening tool in the United States in 1960, incidence declined nationwide, the researchers reported. However, the findings from their analysis uncovered (https://onlinelibrary.wiley.com/doi/full/10.1002/ijc.34860) more recent increases in cervical cancer incidence and mortality in low-income counties, which have an average household income of $19,330–$38,820.

The researchers found that (https://onlinelibrary.wiley.com/action/downloadSupplement?doi=10.1002/ijc.34860&file=ijc34860-sup-0001-Supinfo.pdf) non-Hispanic White individuals in low-income regions, whose incidence rates of distant-stage cervical cancer rose an average of 4.4% per year from 2004–2019 and mortality an average of 1.1% per year from 2005–2019, bear the brunt of the disparity. Among non-Hispanic Black patients, cervical cancer mortality rates increased (https://onlinelibrary.wiley.com/action/downloadSupplement?doi=10.1002/ijc.34860&file=ijc34860-sup-0001-Supinfo.pdf) by 2.9% per year from 2013–2019. Hispanic individuals currently represent the highest absolute number of cases, with their incidence of distant-stage cervical cancer increasing (https://onlinelibrary.wiley.com/action/downloadSupplement?doi=10.1002/ijc.34860&file=ijc34860-sup-0001-Supinfo.pdf) an average of 1.5% per year from 2004–2019.

Although evidence-based prevention measures such as human papillomavirus vaccination (https://voice.ons.org/news-and-views/single-hpv-vaccine-dose-may-be-enough-to-prevent-cancer), cytologic screening (https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/cervical-cancer-screening), and early detection have led to significant decreases in cervical cancer incidence and mortality, the latest findings suggest that socioeconomic factors and other social determinants of health are driving a divide in cervical cancer outcomes.

The findings also highlight a need for continued funding and legislative health policies (https://voice.ons.org/advocacy/more-than-a-shot-in-the-arm-policymakers-and-providers-must-support-a-sustained-case-for) that support access to disease-preventing vaccinations, including HPV vaccines to prevent cervical cancer. Particularly if you live in or care for patients in a low-income area, your oncology nursing stories provide critical evidence that your local, state, and national legislators can use to create real change. The American public has rated nursing as the most ethical and trusted profession for 24 years (https://nursejournal.org/articles/nurses-ranked-the-most-trusted-profession-2023/#:~:text=People%20have%20ranked%20nurses%20as,events%20of%20September%2011%2C%202001.) and counting (https://www.nursingworld.org/news/news-releases/2024/americas-most-trusted-nurses-continue-to-rank-the-highest/), and lawmakers place incredibly high value on your voice.

Visit the ONS Action Center (https://www.votervoice.net/ONS/Home) to learn how to contact your representatives.