It’s easy to think cervical cancer could be 100% preventable. Along with lung, breast, and colorectal cancer, it has screening tests to find precancerous changes that can be treated before full-blown cancer develops. Even more, there is a highly effective vaccine against HPV, the virus that causes most cervical cancer diagnoses, demonstrating the importance of addressing the rural-urban divide in cervical cancer screening and cases.

Still, those two forms of prevention are not enough if people aren’t getting them, a research letter published Monday in JAMA Network Open reports. The cross-sectional study found incidence and mortality rates have been climbing in rural counties in the United States since 2012, going in the wrong direction after declining since 2001. Cases were 25% higher and deaths were 42% higher in rural counties compared to urban counties through 2019.

Researchers said those jumps in incidence and mortality showing up in rural areas may be a result of lower screening, diagnosis, and treatment rates, all an offshoot of reduced options for care outside cities.

There was also a trend toward higher incidence among Black women starting in 2017, but that rise was not statistically significant. Other research, from the American Cancer Society, has concluded the mortality rate for Black women is roughly 65% higher than the rate for white women.

“The fact that we’re finding higher incidence and higher mortality, that’s very concerning from a cancer that is mostly preventable,” Trisha Amboree, assistant professor of public health sciences at the Medical University of South Carolina and lead author of the study, told STAT.

Her team’s data follow encouraging news released last week by the Centers for Disease Control and Prevention on the impact of the HPV vaccine. Looking at women 20 to 24 years old, researchers found that rates for precancerous lesions plummeted by about 80% among women screened for cervical cancer. That result squares with the agency’s 2006 recommendation that the vaccine be given to girls at age 11 or 12 followed by 2011 guidance for boys the same age.

Read the full article about the rural-urban divide in cervical cancer cases by Elizabeth Cooney at STAT News.