Cervical Cancer in North America

The prevalence of cervical cancer across North America in 2002 was 8.3 women per 100,000.  This figure, which can be broken down to 8.2 per 100,000 women in the US and 8.7 per 100,000 women in Canada, is fairly low compared to the global average of 12.4 per 100,000 women (derived from Ferlay et al 2004).

The age-standardised incidence of cervical cancer in North America is 7.7 cases per 100,000 women per year, compared to a worldwide incidence of 16.2 per 100,000.  There overall incidence of cervical cancer is the same in Canada and the US (Ferlay et al 2004).  Local variation in the incidence of the disease has been well documented in the US, for example 6.6 cases per 100,000 women are seen in Utah, compared with 8.6 per 100,000 in New Mexico and 12.1 per 100,000 in Los Angeles (SEER Cancer Statistics Review 2005).

(Reference: Ferlay et al 2004)

The age-standardised mortality rate from cervical cancer in North America is similarly low, at 2.3 deaths per 100,000 women per year, compared to a worldwide mortality of 9.0 per 100,000.  There is a small amount of variation in the mortality due to cervical cancer in Canada (2.5 per 100,000) and the US (2.3 per 100,000).  Local variations in the mortality due to cervical cancer are also seen within the US, with 1.6 deaths per 100,000 women in Utah, 2.4 per 100,000 in New Mexico and 3.6 per 100,000 in Los Angeles (SEER Cancer Statistics Review 2005).

(Reference: Ferlay et al 2004)

The relatively low prevalence, incidence and mortality of cervical cancer in North America may reflect the availability of a well-established opportunistic screening programme.  This enables the early detection of cervical abnormalities, and in many cases these abnormalities can be successfully managed and treated before an invasive cervical cancer can develop (Schiller and Davies 2004).  One significant downside to this approach is the number of women diagnosed with precancerous lesions or other cytological abnormalities, a diagnosis that is associated with significant anxiety (Lerman et al 1991; Bell et al 1995).  In the US alone, 55 million cervical screening tests are performed every year, with up to 6.9% thought to yield positive or inconclusive results (Davey et al 2000).

A structured screening programme is nonetheless a cost-effective way of preventing a large number of cervical cancers, particularly if employed on a biennial or triennial basis (Sawaya et al 2003; Taylor et al 2000), although the regularity at which women are screened varies between health insurance systems and may depend on whether a woman can afford to access opportunistic screening (Rodriguez et al 2005).

However, despite the impact of screening, 14,500 women a year are diagnosed with cervical cancer in North America, and nearly 6000 will die from the disease (Ferlay et al 2004). 

Read more about the geography of cervical cancer in: Africa, Asia/Pacific, Latin America, Europe.