Disparities in cervical cancer elimination timeframes in the United States: a comparative modeling study

Abstract

Population-level estimates in timeframes for reaching cervical cancer (CC) elimination (ie, <4 cases per 100,000 women) in the United States may mask potential disparities in achieving elimination among sub-populations. We used three independent Cancer Intervention and Surveillance Modeling Network (CISNET) models to estimate differences in the time to CC elimination across seven strata of correlated screening and human papillomavirus vaccination uptake, based on national survey data. Compared to the average population, elimination was achieved ≥22 years earlier for the high-uptake strata and ≥27 years later for the most extreme low-uptake strata. Accounting for correlated uptake impacted the population average timeframe by ≤ 1 year. Consequently, national average elimination timeframes mask substantial disparities in reaching elimination among sub-populations. Addressing inequalities in CC control could shorten elimination timeframes and would ensure more equitable elimination across populations. Furthermore, country-level elimination monitoring could be supplemented by monitoring progress in sub-populations.