Cervical Cancer Declines Vary by Race US | ACS Analysis

Understanding the Latest ACS Analysis on Cervical Cancer Trends

The American Cancer Society's (ACS) recent analysis reveals striking variations in cervical cancer incidence declines across racial and ethnic groups in the United States. While overall rates have stabilized after decades of reduction thanks to screening and HPV vaccination, the progress is uneven. Non-Hispanic Black, American Indian/Alaska Native (AIAN), and Hispanic women continue to face higher incidence and mortality, highlighting persistent disparities rooted in access to care and social determinants of health (SDOH). 51 50

This new report, part of ACS's Status of Cancer Disparities in 2025, draws from 2018-2022 incidence data and 2019-2023 mortality figures, age-adjusted to the 2000 US standard population. It underscores how declines that began in the 1970s—driven by Pap testing—have slowed, with incidence stable since 2013 and mortality dropping just 0.7% annually since 2003. 50 For researchers and public health professionals at universities nationwide, these findings call for targeted interventions to equitably distribute prevention benefits.

Current Incidence and Mortality Rates by Race and Ethnicity

According to ACS data, cervical cancer incidence varies significantly. In 2018-2022, the age-adjusted rate was 9.7 per 100,000 women overall, but ranged from 5.8 among Hispanic women to 16.1 among AIAN women. 50 Detailed breakdowns include:

• Non-Hispanic White: 9.0 (or 7.0 in disparities report)
• Non-Hispanic Black: 12.1 (8.2)
• AIAN: 16.1 (11.6)
• Asian/Pacific Islander (AAPI): 6.7 (9.7)
• Hispanic: 12.2 (5.8)

Mortality follows suit, with overall 3.0 per 100,000, but 5.0 for Black and 5.1 for AIAN women—55-80% higher than White women's 2.9. 50 These gaps persist even after adjusting for hysterectomy prevalence, pointing to true disease burden differences.

Source: ACS Cancer Facts & Figures 2026. 50

Historical Trends: Uneven Declines Across Groups

Cervical cancer rates plummeted over 50% from 1975 to 2010 due to screening, but trends diverge by race. From 2012-2021, incidence declined ~1% annually in Black women (from 18 to 8 per 100k since 1995), while stabilizing in White women. 49 Adenocarcinoma rates rose in non-Hispanic Whites aged 40-59, contrasting squamous cell carcinoma declines in Black and Hispanic women. 53

AIAN incidence increased recently, per some studies, amid low screening. 55 Hispanic rates remain elevated due to HPV prevalence and barriers. University-led SEER analyses confirm these patterns, emphasizing histological differences—squamous higher in minorities, adenocarcinoma in Whites.

HPV Vaccination: A Key Factor in Disparities

Human papillomavirus (HPV), the primary cause of cervical cancer, is preventable via vaccination. Uptake varies: 69% of Black adolescent girls are up-to-date vs. 63% White, contributing to Black incidence declines. 49 Overall teen rates: 64% girls, 59% boys (2023), with rapid rises since 2016. 88

Yet, young adults show gaps—lower in Hispanics and immigrants. 81 Early low initiation in Black/Hispanic teens risked widening gaps, but equity improvements narrowed them. Research from universities like UNC shows reverse disparities possible with targeted campaigns.

Screening Rates and Access Challenges

Up-to-date screening (per ACS guidelines, ages 25-65): 79.6% NH White, 75.7% Black, 68% AIAN, 63.7% AAPI, 68.4% Hispanic (2023). 51 NHIS data shows stable ~84% overall pre-pandemic, dips during COVID, with Black/Hispanic often higher self-reported but lower records-confirmed. 90

• Rural/non-metro: 3-7 pts lower
• Uninsured: 76% not up-to-date
• Low SES: poverty, no transport key barriers

Universities like those contributing to NHIS analyses stress electronic reminders and community outreach to boost equity.

Root Causes of Persistent Disparities

Disparities stem from SDOH: poverty (21% AIAN vs 8% White), uninsured (25% Hispanic), rural access shortages. 51 Black women diagnosed later (43% late-stage vs Whites), despite screening. 72 HPV strains, obesity, smoking higher in some groups. Medicaid non-expansion states (South) exacerbate, with 36% higher rural mortality. 51

AIAN face cultural mistrust, geographic isolation; Hispanics language barriers. University public health programs advocate policy fixes like expanded telehealth.

Spotlight on High-Burden Groups

Black Women: 17-67% higher incidence, 50% mortality; yet declining faster via vax.AIAN: Twice White rates, screening 68%.Hispanic: 40% higher incidence, variable screening.

Survival: 59% Black vs 68% White (5-yr). 50 Localized diagnosis lower in minorities.

University Research Driving Insights and Solutions

ACS collaborates with university epidemiologists; SEER (NCI-funded, uni-affiliated) provides data backbone. Studies from Emory, UNC detail vax impact; rural disparities from CDC/PCD (uni contributors).

For aspiring researchers, higher ed research jobs in oncology epidemiology abound, advancing equity.

Pathways Forward: Prevention and Policy

• Boost screening to 84%+ (Healthy People 2030)
• Universal HPV vax catch-up
• Address SDOH: transport, insurance
• AI/self-sampling for hard-to-reach

Projections: with equity, elimination possible by 2030 in high-screening groups; lags elsewhere risk 13k+ cases/4k deaths in 2026. 50

Photo by National Cancer Institute on Unsplash

Implications for Public Health Careers

This ACS analysis spotlights need for diverse researchers. Explore higher ed career advice for oncology paths, rate professors in epidemiology, or browse higher ed jobs in cancer research.