Nearly all cervical cancers can be prevented, yet Texas has the eighth-highest rate of new cases and the sixth-highest death rate in the nation. A new five-year statewide plan lays out how to change that.
The Texas Lone Star Cervical Cancer Elimination Plan 2027–2032 was developed by the Cervical Cancer Elimination Priority Area Workgroup, supported by the Cancer Alliance of Texas, the state’s cancer control coalition. It draws on a stakeholder survey conducted from November 2025 to January 2026 and a virtual summit of more than 250 participants, and is designed to line up with the 2024 Texas Cancer Plan.
Where Texas Stands
Texas records 9.5 new cervical cancer cases per 100,000, compared with 7.5 nationally, and a death rate of 2.8 per 100,000, compared with 2.2 for the U.S. The plan defines “elimination” as fewer than 4 new cases per 100,000 per year. In some Texas counties, the rate runs between 15 and 21 new cases per 100,000 women.
Too many cases are also found late. Texas Cancer Registry data from 2014 to 2018 show 44.6% of cervical cancers were diagnosed at a late stage, compared with 42.1% at an early stage. Clusters of late-stage diagnosis appeared in South Texas, parts of North Texas and the Houston/Gulf Coast region, areas that also have higher poverty, more uninsured residents and more barriers to care. Texas has the highest uninsured rate in the country and is not a Medicaid expansion state, the plan notes.
Three Pillars, Three 80% Goals
The plan rests on vaccination, screening and treatment, each with a target for 2032.
Vaccination. The goal is for 80% of Texas boys and girls to be up to date on human papillomavirus (HPV) vaccination by age 15, up from 50.5%. Nationwide, 58.7% of teens were up to date in 2024, and Texas has the ninth-lowest rate in the country, according to the plan. The plan says vaccination can prevent nearly 90% of the cancers HPV causes. To close the gap, it calls for “a clear, confident, and routine recommendation from a clinician,” backed by electronic health record prompts, standing orders and clinic champions, along with vaccine access at pharmacies, schools, community health fairs and back-to-school events.
Screening. The target is for 80% of Texas women to be up to date on screening under current national guidelines, up from 64%. Rates fall below 60% among uninsured and underinsured women, and the eight counties with the lowest Pap-test coverage are all rural or border counties, according to the plan. Liberty County, east of Houston, is on the list, though the plan’s county estimates carry wide margins of error.
The plan also calls primary HPV testing and HPV self-collection a “paradigm shift,” saying self-collection is as accurate as clinician-collected samples for detecting high-risk HPV. It wants both offered in clinics, with an emphasis on safety-net settings, and wants self-collection offered through mobile health units, pharmacies and community events.
Follow-up and treatment. The third goal is for 80% of women who need diagnostic follow-up or treatment for a precancer or cancer to receive it by 2032. The starting point is unknown; the plan estimates it at 40% to 50%. It points to patient navigation, community outreach and provider training, including colposcopy and LEEP training and Project ECHO tele-mentoring, and cites a meta-analysis in which multicomponent programs were substantially more effective than single-component ones at getting women through follow-up care.
“Cancer screening is not a single event, it’s a process,” Dr. Keith Argenbright of the Moncrief Cancer Institute says in the plan. “A screening is just step one. If something looks suspicious, we need to follow up.”
What It Means for Houston
Several programs tied to Houston institutions appear in the plan. Through Project ACCESS, led by Jane Montealegre of The University of Texas MD Anderson Cancer Center and funded by the Cancer Prevention and Research Institute of Texas (CPRIT), HPV self-collection has been added as a screening option in safety-net settings, including Harris Health System, which serves the Houston area. Patient navigators help run the program in clinics and assist patients whose results require follow-up. “Patients often express their contentment with the convenience of self-collection and how quick and easy the process is,” patient navigator Raquel Hernandez says in the plan.
Harris Health also operates the Troubleshooters for Health Immunization Program, which the plan cites as an example of mobile outreach, taking childhood immunizations to schools, daycare centers, churches, housing complexes and public events. MD Anderson’s HPV Vaccination Initiative supported HPV CHAT, a training program for clinic teams on making strong, consistent HPV vaccine recommendations; more than 400 people have participated.
What the Plan Leaves Open
The plan sets targets but does not put a dollar figure on reaching them. It calls “securing funding” an important priority for the coming decade and says CPRIT’s “continued leadership, funding, and commitment to innovation” will be instrumental. It also calls for better integration of vaccination, screening, diagnosis, treatment and cancer registry data, and for statewide dashboards to track progress. Its strategies are a guide that will need to be adapted to specific areas and populations, and groups that adopt them are asked to plan for their own data collection and evaluation.
“No Texan should suffer from or lose their life to cervical cancer if we could prevent it,” says Ludivina Hernández, a cervical cancer survivor and community outreach coordinator, in the plan. “Early detection, screening, and vaccination can prevent unnecessary suffering and save lives.”
The full plan is available from the Texas Cancer Plan website.
