Abstract A109: Birth cohort trends in cervical cancer incidence rates by race and ethnicity in the United States from 1929-1999

Abstract

Human papillomavirus (HPV) vaccination, introduced in the United States in 2006, has been associated with declines in cervical cancer incidence among young women, particularly among generations eligible for vaccination. However, national analyses can mask differences across racial and ethnic groups that vary in vaccination uptake, screening participation, and baseline cervical cancer risk. Therefore, we quantified birth cohort-specific cervical cancer incidence trends by race and ethnicity. We obtained annual invasive cervical cancer incidence data for women aged 20-79 years diagnosed from 2004-2023 across all 50 states and the District of Columbia from the U.S. Cancer Statistics Public Use Database. Analyses were stratified into five racial and ethnic groups: non-Hispanic White (NHW), non-Hispanic Black (NHB), non-Hispanic American Indian and Alaska Native (NH-AIAN), non-Hispanic Asian American or Pacific Islander (NH-AAPI), and Hispanic. For each group, rate matrices were constructed by 5-year age group and 5-year diagnosis period, yielding 15 overlapping 10-year birth cohorts, referenced by the mid-birth cohort year, from 1929 (1924-1933) through 1999 (1994-2003). Age-period-cohort models estimated fitted birth cohort-specific incidence rates at ages 30-34 years, adjusted for period deviations. Incidence rate ratios compared fitted rates for cohorts in the 1990s with those in the 1970s. Analyses were performed in MATLAB R2025b. Fitted incidence rates among women aged 30-34 years declined across successive birth cohorts for most groups, with the largest reductions among NHB and NHW women. Between the 1970s and 1990s birth cohorts, incidence rates decreased from 9.5 to 3.5 per 100,000 population among NHB women, from 11.4 to 4.4 among NHW women, and from 11.7 to 6.1 among Hispanic women, corresponding to reductions of 63%, 62%, and 48%, respectively. Smaller nonsignificant reductions occurred among NH-AIAN women, from 14.9 to 10.1 per 100,000, and NH-AAPI women, from 4.7 to 3.7 per 100,000 women. Consequently, the ranking of racial and ethnic groups by incidence rates shifted across generations. Among women born in the 1990s, NHB women had the lowest fitted incidence rates, followed by NH-AAPI, NHW, Hispanic, and NH-AIAN. This reversed the pattern among women born in the 1930s, when Hispanic and NHB women had the highest incidence rates, followed by NH-AIAN, NHW, and NH-AAPI. Cervical cancer incidence declined substantially among recent birth cohorts across most races and ethnicities, but the magnitude of these declines varied. Differences in HPV vaccination uptake and screening participation likely influenced the varying birth cohort trajectories by race and ethnicity. Distinct birth cohort trajectories by race and ethnicity highlight opportunities for more tailored and targeted prevention efforts. Kieran Kelly, Chenxi Jiang, Angela Giaquinto, Philip Rosenberg, Ahmedin Jemal, Hyuna Sung. Birth cohort trends in cervical cancer incidence rates by race and ethnicity in the United States from 1929-1999 [abstract]. In: Proceedings of the 19th AACR Conference on the Science of Cancer Health Disparities; 2026 Oct 18-21; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2026;35(10 Suppl):Abstract nr A109.