2026/02/17 by Chenxi Jiang, Philip S. Rosenberg, Jessica Star +4 · 1 voice
Medicine · #Cervical Cancer and HPV Research #Endometrial and Cervical Cancer Treatments #Head and Neck Cancer Studies
paper · doi:10.1093/jnci/djag051
openalex publication_date 2026/02/17 · openalex created_date 2026/02/25 · openalex updated_date 2026/07/29
BACKGROUND: Despite well-documented national declines in cervical cancer incidence among young women following human papillomavirus (HPV) vaccine implementation, state-level data remain limited. METHODS: Using the US Cancer Statistics Database, differences in cervical cancer incidence rates for women aged 20-31 between the pre-vaccination (2000-2005) and vaccination era (2016-2021) were estimated using rate ratios (RRs) across 47 states and the District of Columbia (DC). Associations between HPV vaccination rates from the National Immunization Survey-Teen and RRs were examined using Spearman's rank test and linear regression models, adjusted for screening rates from the Behavioral Risk Factor Surveillance System. RESULTS: Nationwide, cervical cancer incidence rates declined by 27% (RR = 0.73, 95%CI:0.70 to 0.75) during the vaccination era, from 5.1 to 3.7 per 100,000. Reductions exceeded 50% in DC (RR = 0.48, 95%CI : 0.15 to 0.81), Rhode Island (RR = 0.48, 95%CI : 0.21 to 0.76), Michigan (RR = 0.48, 95%CI : 0.38 to 0.57), and Hawaii (RR = 0.49, 95%CI : 0.21 to 0.78), with 28 additional states achieving statistically significant reductions of 15-50%. Ten states showed slower decreases (<15%). Notably, progress was lacking in Vermont (RR = 1.11; 95%CI : 0.21 to 2.00), West Virginia (RR = 1.09; 95%CI : 0.63 to 1.56), Idaho (RR = 0.97; 95%CI : 0.42-1.52), Arkansas (RR = 0.96; 95%CI : 0.64 to 1.29), and Alabama (RR = 0.96; 95%CI : 0.71 to 1.21). Across states, higher vaccination rates were correlated with lower RRs (i.e., faster decline) (rho=-0.42, P = .0027). Every 10% increase in vaccination rates was associated with an 11.5% (95%CI : -17.2% to -5.4%) reduction in RRs, adjusted for screening rates. CONCLUSIONS: Declines in cervical cancer incidence in young women during the HPV vaccination era varied substantially by state, aligning with HPV vaccination rates.