Cervical carcinoma rates among young females in the United States

Abstract

Objective: All national organizations now recommend that women be screened for cervical cancer beginning at age 21 years, regardless of age of sexual initiation; however, studies have shown that providers continue to screen much earlier than recommended. Two federal cancer surveillance systems were used to quantify the burden of invasive cervical carcinoma among women younger than 40 years of age.

Methods: We examined combined data from the National Program of Cancer Registries and the Surveillance, Epidemiology, and End Results Program covering 92% of the U.S. population. We calculated the age-adjusted incidence of cervical carcinoma among women younger than age 40 years by age, race, ethnicity, and histology for the time period of 1999-2008.

Results: For women younger than age 40 years, 78% of the cervical cancer cases were diagnosed in women aged 30-39, 21% were diagnosed in women 20-29 years of age, and 1% was diagnosed in women younger than age 20 years. There was an average of 3,063 cases of invasive cervical carcinomas annually from 1999 through 2008, with an average of 14 carcinomas per year (rate of 0.15 per 100,000 females) among those aged 15-19 years, and 125 carcinomas per year (rate of 1.4 per 100,000 females) among those aged 20-24 years.

Conclusion: Cervical cancer is very rare in young women. Widespread implementation of Pap testing over the past four decades has detected very few cases of cervical cancer in women younger than 25 while potentially causing harm with unnecessary follow-up interventions.

Level of evidence: III.

Fig. 1

Recent trends in cervical carcinoma among females younger than 40 years of age from the National Program of Cancer Registries and Surveillance, Epidemiology, and End Results (SEER) program, 1999–2008. The estimated rates for ages 0–19 years are too close to zero to graph (rates range from 0 to 0.06). *The annual percent change is significantly different from zero (P<.05). Data from the Centers for Disease Control and Prevention’s National Program of Cancer Registries and National Cancer Institutes’ SEER Program covering 92% of the United States population for 1999–2008. Rates are per 100,000 and age-adjusted to the 2000 United States Standard Population (single ages to 84, Census P25–1130 standard). Benard. Cervical Carcinoma Among Young Females. Obstet Gynecol 2012.

Fig. 2

Trends in cervical carcinoma among females younger than 40 years of age from the National Program of Cancer Registries (National Program of Cancer Registries) and Surveillance, Epidemiology, and End Results (SEER) program, 1973–2008. The estimated rates for ages 0–20 years are too close to zero to graph (rates range from 0 to 0.15). *The annual percent change is significantly different from zero (P<.05). Data from the Centers for Disease Control and Prevention’s National Program of Cancer Registries and National Cancer Institutes’ SEER Program covering 92% of the United States population for 1999–2008. Rates are per 100,000 and age-adjusted to the 2000 United States Standard Population (single ages to 84, Census P25–1130 standard). Benard. Cervical Carcinoma Among Young Females. Obstet Gynecol 2012.