Let’s start with the bad news: Cervical cancer is the fourth most common cancer in women worldwide, with nearly 14,000 new cases and 4,300 deaths in 2023. This is particularly tragic since it’s also one of the most preventable cancers, thanks to early screening and HPV vaccines.
At the close of Cervical Cancer Awareness Month, we can — and we must — take real steps to lower the rate of unnecessary cervical cancer diagnoses and deaths and increase HPV vaccination rates. This goal is within our reach. That’s the good news.
Cervical cancer diagnoses are most common in women ages 35 to 44, according to the American Cancer Society, though the average age of diagnosis is 50. One in five cervical cancers is diagnosed in women over 65, but older women are rarely diagnosed if they get regular screening through Pap tests.
By identifying abnormal cells that can lead to cervical cancer, women can understand they are at elevated risk of cervical cancer and take appropriate screening and preventive measures. But many women don’t even know they are at elevated risk of cervical cancer as they age.
More than 9 out of 10 cervical cancer cases are caused by the human papillomavirus, or HPV, a virus that is usually spread through sexual contact. In addition to cervical cancer, HPV also causes throat, head, neck, anal, penile and vaginal cancers.
In all, HPV causes nearly 40,000 new cases of cancer each year, more than half among women. According to the National Institutes of Health, the rate of new cervical cancer cases in 2020 was 6.1 per 100,000, down nearly 30 percent from 2000, when the rate was 8.8 per 100,000.
Cervical cancer used to be a leading cause of death for American women, but two main factors have helped change that.
First, there is widespread screening with Pap tests, which can detect abnormal cells that signify cancer or precancer.
Second, the introduction of the HPV vaccine, which protects people from infections that can cause cancer, has been a game changer. Since its introduction in 2006, cancer-causing HPV infections and genital warts have dropped more than 80 percent in teen girls and young women. Women ages 20 to 24, those in the first group to receive the vaccine, had a 65 percent drop in cervical cancer rates between 2012 and 2019.
The benefits of HPV vaccines appear to be long-lasting: A study of people who were followed for more than a decade after getting the vaccine showed that they maintained protection from the vaccine over that time.
According to the Centers for Disease Control and Prevention (CDC), the HPV vaccine has the potential to prevent 90 percent of HPV-associated cancers. Yet, despite the tremendous positive results the HPV vaccine has already generated and what it could do moving forward, vaccination rates are not where they could or should be.
The most recent estimates show that only about 60 percent of teens had gotten two to three doses in 2021. One study showed even lower rates and evidence that, during the pandemic, the rates sunk even lower.
While the Food and Drug Administration approved the vaccine for use in girls and boys at age 9, the current CDC recommendation is for routine vaccination of two doses by age 11 or 12. An additional dose can be recommended depending on the age of vaccination beyond the initial recommendation.
With 2 out of 5 girls and boys ages 11 to 12 — if not more — not getting this vital protection, we need to regain the ground we lost during the pandemic and aim higher to ensure all teens get vaccinated. Though preventing HPV may not be the topic around most Americans’ dinner tables, this is a time to shine a light on the needs and opportunities to prevent HPV-associated cancers.
Jan. 22 started HPV Prevention Week, with “Us vs. HPV” webinars going on throughout the week. These events were designed to promote awareness about HPV and HPV-related diseases.
As a global partner in this effort, HealthyWomen stands with dozens of other organizations dedicated to reaching more people with the message that HPV infections and the cancers they cause are preventable with a safe and effective vaccine. But the vaccine only works if people know about it and receive it as recommended.
Congress is taking notice. On Jan. 24, members of Congress took part in the educational briefing, “Preventing HPV-Related Cancers through Vaccination and Screening.” But they need to do more. The PREVENT HPV Cancers Act was reintroduced in the House on May 24, 2023. It is time for it to be passed again by the House, taken up by the Senate and finally made a reality.
The Biden administration has taken important steps but can also do more. The administration’s Cancer Moonshot, which aims to reduce cancer death rates by at least 50 percent over the next 25 years, allocated $15 million of its fiscal 2024 budget to encourage HPV vaccine uptake. That’s a good start, but just a step in the right direction toward reducing HPV-related cancers and deaths.
This initiative could play a major role in moving the needle on HPV infections and associated cancers. For example, the Cancer Moonshot could encourage a shift in guidelines to make the HPV vaccination routine at age 9, the age at which it is already approved.
The moonshot can also spearhead education campaigns to encourage health care providers to create outreach strategies to remind parents about the HPV vaccines and the need to follow routine vaccination recommendations.
Policymakers and health care professionals alike should also focus on improving equitable access to screening and vaccinations by reaching communities that may have been traditionally more hesitant to accept vaccines and that may face more obstacles to health care access.
This focus on health equity in HPV vaccination rates is essential. According to the CDC, cervical cancer cases are not equitably distributed.
Hispanic (8.4 per 100,000), Indigenous (8.4 per 100,000) and Black Americans (7.3 per 100,000) all have higher rates of cervical cancer. The mortality rate from cervical cancer is highest among Black women — 3.2 per 100,000 compared with 2.1 per 100,000 among white women.
This month, when we honor Dr. Martin Luther King Jr., let’s also honor American women — and American women of color in particular — by prioritizing their health and preventing unnecessary infections, cancers and deaths.
Martha Nolan, J.D., is a senior policy adviser for HealthyWomen.