Clinical Report: Cervical Cancer Trends Differ by Age

Overview

Cervical cancer incidence trends in Puerto Rico from 2001 to 2023 show declines among women under 35 years and increases among those aged 35 to 49 years. The findings highlight the importance of HPV vaccination and the need for improved screening and follow-up care, particularly in the context of the overall incidence rates.

Background

Cervical cancer remains a significant public health issue, particularly in Puerto Rico, which has one of the highest incidence rates in the U.S. Understanding age-specific trends in cervical cancer incidence is crucial for developing targeted prevention and intervention strategies. The introduction of HPV vaccination has the potential to impact these trends, particularly among younger women.

Data Highlights

Key Findings

• Cervical cancer incidence in Puerto Rico is 11.5 cases per 100,000 women, exceeding the WHO elimination target.
• Hysterectomy-corrected incidence rates showed an overall increase of about 3% annually from 2001 to 2014, followed by a decrease of about 3% annually from 2014 to 2023.
• Among women under 35 years, incidence rates increased until 2010, then stabilized, and declined significantly from 2019 to 2023.
• Women aged 35 to 49 years experienced a statistically significant increase in incidence rates throughout the study period.
• Stable cervical cancer screening uptake in Puerto Rico is around 79%, but external factors such as Hurricane Maria and the COVID-19 pandemic may have impacted access to care.
• The study emphasizes the need for public health interventions targeting women aged 35 to 49 years.

Clinical Implications

Healthcare providers should prioritize cervical cancer screening and follow-up care, especially for women aged 35 to 49 years, given the rising incidence in this group. Additionally, promoting HPV vaccination among younger women is crucial to sustaining the observed declines in cervical cancer rates, while addressing barriers to access.

Conclusion

The study indicates a stabilization of cervical cancer incidence trends in Puerto Rico, with significant declines among younger women attributed to HPV vaccination. However, the increasing rates among women aged 35 to 49 years highlight the urgent need for enhanced screening and public health initiatives.

References

1. Ana P. Ortiz et al., JAMA Network Open, 2023 -- Age Differences in Hysterectomy-Corrected Cervical Cancer Incidence Trends in Puerto Rico, 2001-2023
2. The ASCO Post — Survival Trends for Adolescents and Young Adults With Cancer: 40-Year Analysis
3. the asco post — AACR 2025: Trends in Breast Cancer Incidence for Women Between the Ages of 20 and 49
4. The ASCO Post — Have Breast Cancer Mortality Rates Stopped Declining for Younger Women?
5. American Journal of Epidemiology — Incidence Patterns of Endometrial Cancer in the U.S. by Race/Ethnicity and Age at Diagnosis from 2000 to 2019
6. New Cervical Cancer Screening Guidelines Strengthen Women’s Preventive Health
7. Age Differences in Hysterectomy-Corrected Cervical Cancer Incidence Trends in Puerto Rico, 2001-2023 | Obstetrics and Gynecology | JAMA Network Open | JAMA Network
8. One dose of HPV vaccine as effective as two | National Institutes of Health (NIH)