cervical cancer in montana18vtj92co9zb1qy8011oc0fw-wpengine.netdna-ssl.com/... · incidence of...
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Cervical Cancer in Montana
Heather Zimmerman, MPHMontana Central Tumor Registry
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Incidence of cervical cancer in Montana was about the same as the U.S. overall.From 2007 to 2016 there were 36 new cases and 10deaths each year.
5.7
8.7
0
6
12
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Age-
adju
sted
rate
per
100
,000
wom
en
Montana
U.S.
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About 45% of cervical cancers in Montana are diagnosed at the local stage
0.0%
10.0%
20.0%
30.0%
40.0%
50.0%
60.0%
2007-2008 2009-2010 2011-2012 2013-2014 2015-2016
MTU.S.
Local
Regional
Distant
Unknown
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The rate of cervical cancer was not significantly different among American Indian women compared to White women
6.5
9.4
0 5 10 15
White
AmericanIndian
Age-adjusted rate per 100,000 women
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270 pre-cancerous cervical lesions and in situ cancers diagnosed in MT each year
60.3
63
0
20
40
60
80
2007 2008 2009 2010 2011 2012 2013 2014 2015 2016
Age-
adju
sted
rate
per
100
,000
wom
en
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The rate of in situ cancers and pre-cancerous lesions peaks from ages 25-29
0
50
100
150
200
250
300
Rate
per
100
,000
wom
en
Age group
In situ
Invasive
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Percent of MT Women 21-64 who had a Pap in the past 3 yrs
81
85
83
61
77
81
81
82
93
0 20 40 60 80 100
White
American Indian
Has Insurance
No Insurance
2018(preliminary)
2016
2014
2012
HP 2020 goal
Percent
Preliminary 2018 UDS cervical cancer screening rate is 51.0%
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Cervical Cancer and HPV
• 91% of cervical cancers are caused by Human Papillomavirus (HPV)
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Estimated HPV-Associated Cancers per Year, U.S., 2010–2014
0 1,000 2,000 3,000 4,000 5,000 6,000 7,000 8,000 9,000 10,00011,00012,00013,00014,000
Cervix
Vagina
Vulva
Anus
Oropharynx
Penis
Anus
Oropharynx
Average number of cases per year
Sex / Cancer Site
Mal
eFe
mal
e
can be prevented by 9-valent vaccine
HPV types 16/18 HPV types 31/33/45/52/58 other HPV types HPV-negative*Cancer probably
caused by HPV type
can be prevented by bivalent and quadrivalent vaccines
*HPV DNA was not detected in a percentage of cancers (Saraiya M et al. US assessment of HPV types in cancers: implications for current and 9-valent HPV vaccines. J Natl Cancer Inst. 2015;107:djv086).
Slide from CDC’s You Are the Key Presentation
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Montana’s HPV Coverage RatesNational Immunization Survey – Teen, Montana, 2017
65.5 66.464.5
49.1 48.150.1
HPV overall HPV (male) HPV (female)
≥1 dose
UTD
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Trends in age-specific rates of CIN 2+, United States, 2008-2016
18-19
20-24
25-29
30-34
0
100
200
300
400
500
600
2008 2016
Rate
per
100
,000
wom
en
McClung NM, Gargano JW, Park IU, et al. Estimated Number of Cases of High-Grade Cervical Lesions Diagnosed Among Women — United States, 2008 and 2016. MMWR Morb Mortal Wkly Rep 2019;68:337–343. DOI: http://dx.doi.org/10.15585/mmwr.mm6815a1External.
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Trends in age-specific rates of CIN 3+, Montana, 2007-2016
16-19
20-24
25-29
30-34
0
50
100
150
200
250
300
350
2007 2016
Rate
per
100
,000
wom
en