{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T14:51:46Z","timestamp":1787669506786,"version":"build-2736575974"},"reference-count":67,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2026,2,24]],"date-time":"2026-02-24T00:00:00Z","timestamp":1771891200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Intramural Research Department"},{"DOI":"10.13039\/100000048","name":"American Cancer Society","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000048","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100011541","name":"Division of Cancer Epidemiology and Genetics","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100011541","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Despite well-documented national declines in cervical cancer incidence among young women following human papillomavirus (HPV) vaccine implementation, state-level data remain limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using the US Cancer Statistics Database, differences in cervical cancer incidence rates for women aged 20-31 between the pre-vaccination (2000-2005) and vaccination era (2016-2021) were estimated using rate ratios (RRs) across 47 states and the District of Columbia (DC). Associations between HPV vaccination rates from the National Immunization Survey-Teen and RRs were examined using Spearman\u2019s rank test and linear regression models, adjusted for screening rates from the Behavioral Risk Factor Surveillance System.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Nationwide, cervical cancer incidence rates declined by 27% (RR\u2009=\u20090.73, 95% CI = 0.70 to 0.75) during the vaccination era, from 5.1 to 3.7 per 100\u2009000. Reductions exceeded 50% in DC (RR\u2009=\u20090.48, 95% CI = 0.15 to 0.81), Rhode Island (RR\u2009=\u20090.48, 95% CI = 0.21 to 0.76), Michigan (RR\u2009=\u20090.48, 95% CI = 0.38 to 0.57), and Hawaii (RR\u2009=\u20090.49, 95% CI = 0.21 to 0.78), with 28 additional states achieving statistically significant reductions of 15%-50%. Ten states showed slower decreases (&amp;lt;15%). Notably, progress was lacking in Vermont (RR\u2009=\u20091.11, 95% CI = 0.21 to 2.00), West Virginia (RR\u2009=\u20091.09, 95% CI = 0.63 to 1.56), Idaho (RR\u2009=\u20090.97, 95% CI = 0.42 to 1.52), Arkansas (RR\u2009=\u20090.96, 95% CI = 0.64 to 1.29), and Alabama (RR\u2009=\u20090.96, 95% CI = 0.71 to 1.21). Across states, higher vaccination rates were correlated with lower RRs (ie, faster decline) (rho=\u22120.42, P\u2009=\u2009.0027). Every 10% increase in vaccination rates was associated with an 11.5% (95% CI = \u221217.2% to \u22125.4%) reduction in RRs, adjusted for screening rates.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Declines in cervical cancer incidence in young women during the HPV vaccination era varied substantially by state, aligning with HPV vaccination rates.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jnci\/djag051","type":"journal-article","created":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T12:26:44Z","timestamp":1771331204000},"page":"1395-1402","source":"Crossref","is-referenced-by-count":3,"title":["State-level progress in reducing cervical cancer incidence among US young women between the pre- and post-human papillomavirus vaccination eras"],"prefix":"10.1093","volume":"118","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-9457-0950","authenticated-orcid":false,"given":"Chenxi","family":"Jiang","sequence":"first","affiliation":[{"name":"Surveillance, Prevention, & Health Services Research, American Cancer Society , Atlanta, GA,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6349-9126","authenticated-orcid":false,"given":"Philip S","family":"Rosenberg","sequence":"additional","affiliation":[{"name":"Biostatistics Branch, Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, NIH , Bethesda, MD,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3522-9609","authenticated-orcid":false,"given":"Jessica","family":"Star","sequence":"additional","affiliation":[{"name":"Surveillance, Prevention, & Health Services 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