# The cervical cancer divide: state variation in incidence, mortality, and progress toward elimination in the United States

## TL;DR

This paper examines how cervical cancer rates and progress toward elimination vary across U.S. states, highlighting significant regional disparities.

## Contribution

The study provides a detailed state-level analysis of cervical cancer incidence and mortality to guide targeted interventions.

## Key findings

- Massachusetts was the only state near the cervical cancer elimination threshold in 2021.
- Southeastern and Southwestern states had the highest incidence rates, with Mississippi leading at 14.8 per 100,000.
- Cervical cancer incidence and mortality remained largely unchanged in most states between 2007-2011 and 2017-2021.

## Abstract

Cervical cancer elimination (<4 cases per 100 000) is a critical cancer prevention goal in the United States. Implementation of health policies and allocation of health resources occur at regional and state levels; therefore, understanding region- and state-specific cervical cancer incidence, mortality, and progress toward elimination—and remaining gaps—is essential. We estimated hysterectomy-corrected cervical cancer incidence, mortality, and progress toward elimination across all 50 states, the District of Columbia, and Puerto Rico. In 2021, Massachusetts was the only state nearing (4.3 per 100 000) the elimination threshold. Southeastern and Southwestern states were furthest, with the highest incidence rates in Mississippi (14.8), Louisiana (14.2), and Oklahoma (13.8). The mortality rate ranged from 6.8 (Alabama) to 1.4 (Wisconsin). In most states, cervical cancer incidence and mortality did not change from 2007-2011 to 2017-2021. Identifying and addressing regional- and state-level barriers impeding progress will be key to achieving cervical cancer elimination.