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Cervical Cancer in Montana
Heather Zimmerman, MPHMontana Central Tumor Registry
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.
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
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
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
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
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%
Cervical Cancer and HPV
• 91% of cervical cancers are caused by Human Papillomavirus (HPV)
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
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
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.
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