WEDNESDAY, Aug. 20, 2025 (HealthDay News) -- Women in counties with repeatedly lower cervical cancer screening rates have nearly double the rate of cervical cancer incidence and mortality as counties with repeatedly high rates of screening, according to a study published online Aug. 13 in JAMA Network Open.
Trisha L. Amboree, Ph.D., from the Medical University of South Carolina in Charleston, and colleagues conducted a cross-sectional study to examine differences in cervical cancer incidence and mortality by county-level screening. The analysis included data from the Surveillance, Epidemiology, and End Results (SEER)-22 database to identify cervical cancer cases among women aged 20 years and older, as well as SEER estimates for county-level cervical cancer screening for 1,086 counties. Counties were categorized as having repeatedly low versus high screening if they had <70 versus ≥80 percent coverage during the 2011 to 2016 period and at least one earlier period (2008 to 2010 or 2004 to 2007). Cervical cancer mortality was determined from death certificate data from the National Center for Health Statistics.
The researchers found that 70 counties were identified as repeat low coverage, 141 as repeat high coverage, and 875 as other. Most repeat low-coverage counties were rural (87.1 percent), and all had a median household income of <$75,000. In contrast, most repeat high-coverage counties were urban (84.4 percent), and more than half (51.1 percent) had a median household income ≥$75,000. Most repeat low-coverage counties were in Texas (47.1 percent), Idaho (17.1 percent), and New Mexico (17.1 percent). From 2016 to 2021, cervical cancer incidence was 28 percent higher in other-designated counties and 83 percent higher in repeat low-coverage counties compared with high-coverage counties. Compared with high-coverage counties, localized-stage incidence was 22 percent higher in other-designated counties and 75 percent higher in low-coverage counties. For regional stage, risk was 33 and 87 percent higher, respectively, while distant-stage risk was 35 and 84 percent higher in other and repeat low-coverage counties, respectively. Cervical cancer mortality from 2016 to 2021 was 42 percent higher in other and 96 percent higher in low-coverage counties.
"We report nearly twofold higher cervical cancer incidence, late-stage diagnosis, and mortality in counties with repeatedly low versus high cervical cancer screening coverage," the authors write.