Cross-sectional study of rural-urban disparities in cervical cancer incidence and mortality among US women

Women living in rural areas, particularly minoritized populations, face health care shiortages contributing to suboptimal cervical cancer screening and care. Recent evidence shows an increase in cervical cancer incidence in the US; however, rural-urban disparities in cervical cancer incidence and mortality remain unclear. A cross-sectional study using the NPCR-SEER database (2001-2019) identified 222,245 cervical cancer cases, of which 84.3% were from urban counties and 59.9% were in White women. Hysterectomy-corrected incidence rates were 11.9 and 10.0 per 100,000 in rural and urban counties, respectively. Overall, incidence increased by 0.85% per year in rural counties for 2012 to 2019, after decreasing from 2001 to 2012. Conversely, incidence plateaued in urban counties after decreasing during 2001 to 2013. The gap between rural and urban incidence rates widened from 2013 (RR 1.16; 95% CI 1.10-1.22) to 2019 (1.25; 1.19-1.31). Cervical cancer mortality was 1.42 (95% CI 1.33-1.51) times higher in rural versus urban counties during 2015 to 2019. The authors conclude that these findings highlight the importance of enhancing preventive care (HPV vaccination and screening access) in rural US counties.