Within the next decade, Alabama aims to become the first state to eliminate cervical cancer.

Cervical cancer was once one of the most common causes of death for American women, according to the American Cancer Society. But since the 1970s, incidence and mortality rates for cervical cancer in have dropped by more than half, largely due to improved cancer screening and prevention, including Pap tests and the human papillomavirus (HPV) vaccine.

Although overall incidence has decreased over the years, cervical cancer cases among women 30 to 44 increased nearly 2% annually from 2012 to 2019, according to a Wall Street Journal article highlighting Alabama’s leading efforts to eliminate the malignancy. In 2024, an estimated 13,820 new cases of invasive cervical cancer will be diagnosed and about 4,360 women will die of the disease.

Alabama has the fourth highest cervical cancer rate in the country, and Black women and women in rural areas experience higher rates than white women or women in cities. The incidence rate for all races in Alabama is 9.1 per 100,000, significantly higher than the U.S. rate of 7.5 per 100,000, according to the Alabama Department of Public Health (ADPH).

Despite this, physicians believe cervical cancer can be eliminated just as polio and malaria have been.

Director of the Cancer Prevention and Control Division at the ADPH, Nancy Wright, laid out three major steps needed to eliminate cervical cancer:

  • Increase HPV vaccination;
  • Increase cervical cancer screening through HPV/Pap tests; and
  • Ensure women receive additional testing and treatment when screening tests show abnormal cells.

In 2023, ADPH drafted an action plan titled “Operation WIPE OUT to eliminate cervical cancer in Alabama. The plan outlines actions physicians, nurse practitioners, community members and advocates can take to implement these three steps.

Here’s a video on the initiative:

To improve access to screening and prevention, Alabama hospitals have been sending health care buses across the state, especially to areas where gynecologists are limited. With permission from parents, traveling nurse practitioners have vaccinated young girls in middle schools throughout the state.

Although the HPV vaccine has been shown to be highly effective and has been approved for girls and boys as young as 9 years old, some parents worry about side effects or believe the vaccine encourages sexual activity.

The Centers for Disease Control and Prevention recommends HPV vaccination for all boys and girls at ages 11 to 12 to protect against HPV-related infections and cancers.

Alabama is the first and only state in the nation to announce its intent to eliminate cervical cancer, according to Wright.

To read more, click #Cervical Cancer or read Cancer Health’s Basics on Cervical Cancer. It reads in part:

What is cervical cancer?

Cervical cancer develops when cells grow out of control in the uterine cervix. The cervix is the lower part of the uterus (womb), connecting the uterus to the vagina. The most common type of cervical cancer is squamous cell carcinoma. Almost all cases of cervical cancer are caused by human papillomavirus (HPV).

When detected early, treatment is generally effective, and many people can be cured, but more advanced disease is harder to treat.

Who gets cervical cancer?

Cervical cancer is the one of the most common malignancies in women worldwide, and it is a leading cause of cancer-related death for women in developing countries. In the United States, however, cervical cancer is relatively uncommon thanks to routine screening with HPV tests and Pap smears, which can detect abnormal precancerous cells and allow for early treatment. Wider use of the HPV vaccine has also contributed to the decline.

Cervical cancer is typically diagnosed in middle-aged women, and it is seldom seen in women younger than age 20. About 20% of cases occur in women over 65. Women living with HIV and those with advanced immune suppression for other reasons are more likely to develop invasive cervical cancer. 

What are the risk factors for cervical cancer?

The main cause of cervical cancer is HPV infection. There are more than 100 types of HPV, but only about a dozen types are considered high-risk, or cancer-causing. Two types in particular, 16 and 18, are responsible for about a majority of all cervical cancers. HPV is commonly spread through sexual contact, but this can also occur through nonsexual skin-to-skin contact.

How is cervical cancer diagnosed?

Early detection and treatment of cervical cancer increases the likelihood of long-term survival. Routine cervical screening involves Pap smears and testing for HPV. In a Pap test, a clinician collects a small sample of cells from the cervix to examine in a laboratory for abnormal changes.