ObjectiveCervical cancer (International Federation of Gynecology and Obstetrics (FIGO)) stage IVA-B (distant stage) is a rare diagnosis with an approximate 5 year survival rate of 17% and with limited treatment options. The objective of this study was to determine the trends in distant stage cervical cancer in the USA and identify possible factors related to these trends.MethodsData were obtained from the United States Cancer Statistics program from 2001 to 2018. Rates of cervical cancer screening and vaccination were evaluated using the Behavioral Risk Factor Surveillance System and TeenVaxView. SEER*Stat 8.3.8.9.2 and Joinpoint regression program 4.9.0.0 were used to calculate incidence trends.ResultsOver the last 18 years, 29 715 women were diagnosed with distant stage cervical carcinoma. Black women have disproportionately higher rates at 1.55/100 000 versus 0.92/100 000 in White women (p<0.001). When examining the trends over time, there has been an annual increase in distant stage cervical cancer at a rate of 1.3% per year (p<0.001). The largest increase is seen in cervical adenocarcinoma with an average annual percent change of 2.9% (p<0.001). When performing an intersection analysis of race, region and age, White women in the South aged 40–44 have the highest rise in distant cervical cancer at a rate of 4.5% annually (p<0.001). Using the Behavioral Risk Factor Surveillance System and TeenVax data, compared with Black women, we found that White women have a nearly two-fold higher rate of missed or lack of guideline screening, 26.6% vs 13.8%. White teenagers (13–17 years) have the lowest human papillomavirus vaccination rate at 66.1% compared with others at 75.3%.ConclusionsBlack women have a higher incidence of distant stage disease compared with White women. However, White women have a greater annual increase, particularly in adenocarcinomas. Compared with Black women, White women also have lower rates of guideline screening and vaccination.

Highlights The incidence of uterine carcinosarcoma increased over the past 17 years. Black women in the South ages 70–74 had the highest incidence. Uterine carcinosarcoma increased annually by 2.6% in Hispanic women.

The present study aims to compare the rate of depressive symptoms and inflammation levels between sexual minorities and heterosexuals. Data were obtained from the National Health and Nutrition Examination Survey from 2005 to 2010. Depressive-related symptoms were measured using the Patient Health Questionnaire-9 scoring system. C-reactive protein was analyzed with the Behring Nephelometer. Of 8538 participants, 95.8% self-reported as heterosexual and 4.2% as sexual minority. Depressive symptoms were reported in 7.1% of heterosexuals compared to 15.8% in sexual minorities (P = 0.001). In heterosexuals, C-reactive protein was higher in those with depressive symptoms compared to those without (P < 0.001). In sexual minorities, similar results were found, however, it was statistically insignificant. The intersection group of black sexual minority females reported the highest rate of depressive symptoms at 33.4%. We found that depressive symptoms were higher in sexual minorities compared to heterosexuals. Furthermore, systemic inflammation was highest in the intersection group of black sexual minority females.

What is already known on this topic?The incidence of cancer is rising among women; 42% of cancers among men and women are associated with modifiable risk factors.What is added by this report?We used 18 years of population-based data to determine trends in the incidence of cancers that are associated with 5 modifiable risk factors. The incidence of obesity-associated cancer is rising, particularly among women aged 20 to 49 years (vs ≥50 y) and Hispanic women.What are the implications for public health practice?Our findings help advance the understanding of cancer prevention. Studies that examine the effect of obesity on cancers diagnosed among young and Hispanic women are warranted.