Recent trends in racial and regional disparities in cervical cancer incidence and mortality in United StatesReport as inadecuate




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Background

Although black women experienced greater cervical cancer incidence and mortality rate reduction in recent years, they continue to have higher incidence rates than whites. Great variations also exist among geographic regions of the US, with the South having both the highest incidence and mortality rates compared to other regions. The present study explores the question of whether living in the South is associated with greater racial disparity in cervical cancer incidence and mortality by examining race- and region-specific rates and the trend between 2000 and 2012.

Methods

The Surveillance, Epidemiology, and End Results SEER 18 Program data was used. Cervical cancer incidence and mortality rates, annual percent changes, and disparity ratios were calculated using SEER*Stat software and Joinpoint regression for four groups: US14-Non-Hispanic White NHW, US14-Non-Hispanic Black NHB, South-NHW, and South-NHB, where South included 4 registries from Georgia and Louisiana and US14 were 14 US registries except the four South registries.

Results

The average age-adjusted cervical cancer incidence rate was the highest among South-NHBs 11.1 and mortality rate was the highest among US14-NHBs 5.4. In 2012, the degree of racial disparities between South-NHBs and South-NHWs was greater in terms of mortality rates NHB:NHW = 1.80:1.35 than incidence rates NHB:NHW = 1.45:1.15. While mortality disparity ratios decreased from 2000–2012 for US14-NHB APC: -1.9-2.3,-1.4, mortality disparity ratios for South-NHWs although lower than NHBs increased compared to US14-NHW. Incidence rates for NHBs continued to increase with increasing age, whereas rates for NHWs decreased after age 40. Mortality rates for NHBs dramatically increased at age 65 compared to a relatively stable trend for NHWs. The increasing racial disparity with increasing age in terms of cervical cancer incidence rates became more pronounced when corrected for hysterectomy prevalence.

Conclusions

Black race and South region were associated with higher cervical cancer incidence and mortality. Cervical cancer rates uncorrected for hysterectomy may underestimate regional and racial disparities. Increasing incidence rates for older NHBs compared to NHWs warrant further research to determine whether screening should continue for NHBs over age 65.



Author: Wonsuk Yoo , Sangmi Kim, Warner K. Huh , Sarah Dilley , Steven S. Coughlin , Edward E. Partridge , Yunmi Chung , Vivian Dicks , J

Source: http://plos.srce.hr/



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