Cervical cancer is the second most common female tumor worldwide, and its incidence is
disproportionately high
(>80%) in the developing world. In the United States, in which Papanicolaou (Pap) tests have
reduced the annual incidence to approximately 11,000 cervical cancers, >60% of cases are reported
to occur in medically underserved populations as part of a complex of diseases linked to poverty,
race/ethnicity, and/or health disparities. Because car- cinogenic human papillomavirus (HPV)
infections cause virtually all cervical cancer, 2 new approaches for cervical
cancer prevention have emerged: 1) HPV vaccination to prevent infections in younger women (aged
:::18 years) and
2) carcinogenic HPV detection in older women (aged �30 years). Together, HPV vaccination and
testing, if used in an
age-appropriate manner, have the potential to transform cervical cancer prevention, particularly
among underserved populations. Nevertheless, significant barriers of access, acceptability, and
adoption to any cervical cancer prevention strategy remain. Without understanding and addressing
these obstacles, these promising new tools for cervical can- cer prevention may be futile. In the
current study, the delivery of cervical cancer prevention strategies to these US populations that
experience a high cervical cancer burden (African-American women in South Carolina, Alabama, and
Mississippi; Haitian immigrant women in Miami; Hispanic women in the US-Mexico Border; Sioux/Native
American women in the Northern Plains; white women in the Appalachia; and Vietnamese-American women
in Pennsylvania and New Jersey) is reviewed. The goal was to inform future research and outreach
efforts to reduce the burden of cervical cancer in underserved populations. Cancer
2010;116:2531–42. VC 2010 American Cancer Society.