Incidence of testicular cancer in the United States from 1992 to 2009.

2013 ◽  
Vol 31 (6_suppl) ◽  
pp. 339-339 ◽  
Author(s):  
Manas Nigam ◽  
Brisa Aschebrook-Kilfoy ◽  
Sergey Shikanov ◽  
Scott E. Eggener
Keyword(s):  
United States ◽  
Testicular Cancer ◽  
White Men ◽  
The United States ◽  
Incidence Rates ◽  
The Us ◽  
Hispanic Men ◽  
Tumor Characteristic ◽  
Race Ethnicity ◽  
Hispanic White

339 Background: The incidence of testicular cancer (TC) increased in the US through 2003. However, little is known about these trends after 2003. We sought to determine trends in TC incidence based on race, ethnicity and tumor characteristics. Methods: TC incidence and tumor characteristic data from 1992-2009 were extracted from the Surveillance, Epidemiology, and End Results-13 (SEER) registry. Trends were determined using JoinPoint. Results: TC incidence in the US increased from 1992 (5.7/100,000) to 2009 (6.8/100,000) with annual percentage change (APC) of 1.1% (p < 0.001). TC rates were highest in non-Hispanic white men (1992: 7.5/100,000; 2009: 8.6/1000) followed by Hispanic men (1992: 4.0/100,000; 2009: 6.3/100,000) and lowest among non-Hispanic black men (1992: 0.7/100,000; 2009: 1.7/100,000). Significantly increasing incidence rates were observed in non-Hispanic white men (1.2%, p < 0.001) but most prominently among Hispanics, especially from 2002-2009 (5.6%, p < 0.01). A significant increase was observed for localized TC (1.21%, p < 0.001) and metastatic TC (1.43%, p < 0.01). Increased incidence occurred in localized tumors for non-Hispanic white men (1.56%, p <0.001), while Hispanic men experienced an increase in localized (2.6%, p < 0.001), regionalized (16.5% from 2002-09, p < 0.01), and distant (2.6%, p < 0.01) disease. Conclusions: Through 2009, testicular cancer incidence continues to increase in the United States, most notably among Hispanic men. [Table: see text]

Incidence of Testicular Cancer in the United States, 1999-2004

2009 ◽  
Vol 4 (4) ◽  
pp. 353-360 ◽  
Author(s):  
Julie S. Townsend ◽  
Lisa C. Richardson ◽  
Robert R. German
Keyword(s):  
United States ◽  
Testicular Cancer ◽  
Alaska Native ◽  
Germ Cell Tumors ◽  
White Men ◽  
The United States ◽  
Incidence Rates ◽  
Testicular Germ Cell ◽  
Cancer Statistics ◽  
Hispanic White

Testicular cancer is rare but primarily affects young men. To characterize the current incidence of testicular cancer in the United States, U.S. Cancer Statistics data from 1999 through 2004 were examined. Age-adjusted (2000 U.S. standard) incidence rates were calculated for seminoma and nonseminoma testicular germ cell tumors (TGCTs). Hispanic men had the largest increase in incidence rates for nonseminomas, followed by non-Hispanic White men (annual percentage change of 3.2% and 1.9%, respectively, p < .05). Nonseminomas peaked at a younger age for Hispanic, American Indian/Alaska Native (AIAN), and Asian/Pacific Islander (API) men. Whereas 9.6% of TGCTs were diagnosed at a distant stage in non-Hispanic White men, more Hispanic (16.1%), Black (13.8%), AIAN (16.8%), and API (14.9%) men with TGCTs were diagnosed with distant stage. Monitoring incidence rates for rare cancers by race/ethnicity has improved with national population-based cancer registry coverage. Disparities in diagnosis stage have implications for effective treatment of TGCTs.

scholarly journals Alcohol Consumption and Chronic Liver Disease Mortality in New Mexico and the United States, 1999-2013

2018 ◽  
Vol 133 (3) ◽  
pp. 287-293 ◽  
Author(s):  
Laura E. Tomedi ◽  
Jim Roeber ◽  
Michael Landen
Keyword(s):  
United States ◽  
New Mexico ◽  
Liver Disease ◽  
American Indian ◽  
The United States ◽  
Death Rates ◽  
Attributable Fractions ◽  
Hispanic Men ◽  
Race Ethnicity ◽  
Hispanic White

Objective: Current chronic liver disease (CLD) mortality surveillance methods may not adequately capture data on all causes of CLD mortality. The objective of this study was to calculate and compare CLD death rates in New Mexico and the United States by using both an expanded definition of CLD and estimates of the fractional impact of alcohol on CLD deaths. Methods: We defined CLD mortality as deaths due to alcoholic liver disease, cirrhosis, viral hepatitis, and other liver conditions. We estimated alcohol-attributable CLD deaths by using national and state alcohol-attributable fractions from the Centers for Disease Control and Prevention’s Alcohol-Related Disease Impact application. We classified causes of CLD death as being alcohol-attributable, non–alcohol-attributable, or hepatitis C. We calculated average annual age-adjusted CLD death rates during five 3-year periods from 1999 through 2013, and we stratified those rates by sex, age, and race/ethnicity. Results: By cause of death, CLD death rates were highest for alcohol-attributable CLD. By sex and race/ethnicity, CLD death rates per 100 000 population increased from 1999-2001 to 2011-2013 among American Indian men in New Mexico (67.4-90.6) and the United States (38.9-49.4), American Indian women in New Mexico (48.4-63.0) and the United States (27.5-39.5), Hispanic men in New Mexico (48.6-52.0), Hispanic women in New Mexico (16.9-24.0) and the United States (12.8-13.1), non-Hispanic white men in New Mexico (17.4-21.3) and the United States (15.9-18.4), and non-Hispanic white women in New Mexico (9.7-11.6) and the United States (7.6-9.7). CLD death rates decreased among Hispanic men in the United States (30.5-27.4). Conclusions: An expanded CLD definition and alcohol-attributable fractions can be used to create comprehensive data on CLD mortality. When stratified by CLD cause and demographic characteristics, these data may help states and jurisdictions improve CLD prevention programs.

scholarly journals The Association Between Educational Attainment and Diabetes Among Men in the United States

2014 ◽  
Vol 8 (4) ◽  
pp. 349-356 ◽  
Author(s):  
Shanta M. Whitaker ◽  
Janice V. Bowie ◽  
Rachael McCleary ◽  
Darrell J. Gaskin ◽  
Thomas A. LaVeist ◽  
...  
Keyword(s):  
United States ◽  
Educational Attainment ◽  
The United States ◽  
Bachelor's Degree ◽  
Logistic Regression Models ◽  
Hispanic Men ◽  
Race Ethnicity ◽  
The Relationship ◽  
Racial Ethnic ◽  
Hispanic White

Few studies have examined the relationship between education and diabetes among men in the United States and whether this relationship differs by race/ethnicity. This study examined whether racial disparities in diabetes existed by educational attainment in 336,746 non-Hispanic White, non-Hispanic Black, and Hispanic men 18 years of age and older in the United States. Logistic regression models were specified to examine the odds of reporting diabetes by educational attainment. Within race/ethnicity, both White and Hispanic men who had less than a high school education (odds ratio [OR] = 1.42, 95% confidence interval [CI] = [1.19, 1.69], and OR = 1.64, 95% CI = [1.22, 2.21], respectively) had consistently higher odds of diabetes than men with a bachelor’s degree or higher level of educational attainment. Educational attainment did not appear to be associated with reporting a diagnosis of diabetes in non-Hispanic Black men. Identifying why educational attainment is associated with diabetes outcomes in some racial/ethnic groups but not others is essential for diabetes treatment and management.

Remember the Ladies: Competition and Mobilization in the United States

2018 ◽  
pp. 83-132
Author(s):  
Dawn Langan Teele
Keyword(s):  
United States ◽  
Political Geography ◽  
Gilded Age ◽  
Political Competition ◽  
State Legislatures ◽  
The United States ◽  
The Political ◽  
The Us ◽  
Race Ethnicity

This chapter presents a case study of women's enfranchisement in the United States. It argues that the formation of a broad coalition of women, symbolized by growing membership in a large non-partisan suffrage organization, in combination with competitive conditions in state legislatures, was crucial to securing politicians' support for women's suffrage in the states. The chapter first gives a broad overview of the phases of the US suffrage movement, arguing that the salience of political cleavages related to race, ethnicity, nativity, and class influenced the type of movement suffragists sought to build. It then describes the political geography of the Gilded Age, showing how the diversity of political competition and party organization that characterized the several regions mirrors the pattern of women's enfranchisement across the states.

scholarly journals Differential Association of HIV Funding With HIV Mortality by Race/Ethnicity, United States, 1999-2017

2020 ◽  
Vol 135 (1_suppl) ◽  
pp. 149S-157S
Author(s):  
Benedict I. Truman ◽  
Ramal Moonesinghe ◽  
Yolanda T. Brown ◽  
Man-Huei Chang ◽  
Jonathan H. Mermin ◽  
...  
Keyword(s):  
United States ◽  
The United States ◽  
Rate Of Change ◽  
Fiscal Year ◽  
Death Rates ◽  
Black Residents ◽  
Race Ethnicity ◽  
Hiv Funding ◽  
Racial Ethnic ◽  
Hispanic White

Objective Federal funds have been spent to reduce the disproportionate effects of HIV/AIDS on racial/ethnic minority groups in the United States. We investigated the association between federal domestic HIV funding and age-adjusted HIV death rates by race/ethnicity in the United States during 1999-2017. Methods We analyzed HIV funding data from the Kaiser Family Foundation by federal fiscal year (FFY) and US age-adjusted death rates (AADRs) by race/ethnicity (Hispanic, non-Hispanic white, non-Hispanic black, and Asian/Pacific Islander and American Indian/Alaska Native [API+AI/AN]) from Centers for Disease Control and Prevention WONDER detailed mortality files. We fit joinpoint regression models to estimate the annual percentage change (APC), average APC, and changes in AADRs per billion US dollars in HIV funding, with 95% confidence intervals (CIs). For 19 data points, the number of joinpoints ranged from 0 to 4 on the basis of rules set by the program or by the user. A Monte Carlo permutation test indicated significant ( P < .05) changes at joinpoints, and 2-sided t tests indicated significant APCs in AADRs. Results Domestic HIV funding increased from $10.7 billion in FFY 1999 to $26.3 billion in FFY 2017, but AADRs decreased at different rates for each racial/ethnic group. The average rate of change in AADR per US billion dollars was −9.4% (95% CI, −10.9% to −7.8%) for Hispanic residents, −7.8% (95% CI, −9.0% to −6.6%) for non-Hispanic black residents, −6.7% (95% CI, −9.3% to −4.0%) for non-Hispanic white residents, and −5.2% (95% CI, −7.8% to −2.5%) for non-Hispanic API+AI/AN residents. Conclusions Increased domestic HIV funding was associated with faster decreases in age-adjusted HIV death rates for Hispanic and non-Hispanic black residents than for residents in other racial/ethnic groups. Increasing US HIV funding could be associated with decreasing future racial/ethnic disparities in the rate of HIV-related deaths.

Impact of Ethnicity On Incidence and Survival Among Adults with Acute Lymphoblastic Leukemia in the United States; Insights From 2005 SEER Data.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 3069-3069
Author(s):  
Casey L O'Connell ◽  
Pedram Razavi ◽  
Roberta McKean-Cowdin ◽  
Malcolm C. Pike
Keyword(s):  
T Cell ◽  
B Cell ◽  
Ethnic Groups ◽  
Lymphoblastic Leukemia ◽  
The United States ◽  
Incidence Rates ◽  
The Us ◽  
Race Ethnicity ◽  
The Impact ◽  
Racial Ethnic

Abstract Abstract 3069 Poster Board III-6 Background Acute lymphoblastic leukemia (ALL) is an aggressive malignancy whose incidence declines through adolescence and then increases steadily with age. Prognosis appears to be inversely related to age among adults. We sought to explore the impact of race/ethnicity on incidence and survival among adults with ALL in the United States (US). Methods We examined trends in incidence and survival among adults with ALL in the US using the National Cancer Institute's Surveillance, Epidemiology and End Results (SEER) program which includes data from 17 SEER registries. We calculated the incidence rates for the most recent time period (2001-2005) because the classification for ALL subtypes was more complete during this time. For the survival analysis we used the data collected between 1975 and 2005. We categorized race/ethnicity into 5 mutually exclusive categories: non-Hispanic whites (NHW), Hispanic whites (HW), African Americans (AA), Asian/Pacific Islanders (API) and American Indians/Native Alaskans (AI/NA). Hispanic ethnicity was defined using SEER's Hispanic-origin variable which is based on the NAACCR Hispanic Identification Algorithm (NHIA); 11 patients dually coded as black and Hispanic were included in the AA group for our analyses. Few ALL cases were identified among AI/NA, so that group is not represented in the final analyses. We included ALL cases coded in the SEER registry using the International Classification of Disease for Oncology (ICD-0-3) as 9827-9829 and 9835-9837. We excluded cases of Burkitt's leukemia (n=228), cases that were not confirmed by microscopic or cytologic tests (n=132), cases that were reported only based on autopsy data (n=3) and cases whose race/ethnicity were unknown (n=20). The average annual incidence rates per 100,000 for 2001-2005, age-adjusted to the 2000 US standard population were calculated using SEER*Stat Version 6.4.4 statistical software. We used multivariate Cox hazard models stratified by SEER registry and age category to estimate the hazard ratios (HR) and 95% confidence intervals (95% CI) for relative survival of adult ALL cases across race/ethnicity, sex and cell of origin (B- or T-cell). All models were adjusted for the diagnosis era, and use of non-CNS radiation. The model also included an interaction term for age and diagnosis era. We performed a separate stratified analysis of the impact of race/ethnicity on survival within age subgroups (20-29, 30-39, 40-59, 60-69, 70+). Results The highest incidence rate (IR) of ALL was observed for HW (IR: 1.60; 95% CI: 1.43-1.79). HW had a significantly higher IR across all age categories as compared to the other racial/ethnic groups, while AA had the lowest IR. In particular, the observed rate of B-cell ALL among HW (IR 0.77; 95% CI 0.69-0.87) was more than twice that of NHW (IR: 0.29; 95% CI: 0.27-0.32) and more than three times the rate observed among AA (IR: 0.20; 95% CI: 0.15-0.26). In contrast, we did not observe statistically significant variability in the rates of T-cell ALL across race/ethnic groups (overall IR: 0.12; 95% CI: 0.11-0.14). Survival was significantly poorer among AA (HR: 1.26; 95% CI: 1.09-1.46), HW (HR: 1.21; 95% CI: 1.09-1.46), and API (HR: 1.18; 95% CI: 1.06-1.32) compared to NHW with all subtypes of ALL. Among adults younger than 40 with B-cell ALL, survival was significantly poorer among AA (HR: 1.60; 95% CI:1.021-2.429) and HW (HR: 1.53; 95% CI:1.204-1.943) with a non-signficant trend among API (HR: 1.22; 95% 0.834-1.755) compared to NHW. Survival differences between the different racial/ethnic groups were no longer statistically significant among adults with B-cell ALL over the age of 40. For T-cell ALL, survival was significantly poorer among AA (HR: 1.61; 95% CI: 1.22-2.10), HW (HR: 1.49; 95% CI: 1.14-1.93) and API (HR: 1.57; 95% CI: 1.13-2.13), as compared to NHW. A similar survival pattern by age (adults above and below age 40 years) was observed for T-cell as described for B-cell, with AA under 40 having a particularly dismal prognosis (HR: 2.89; 95% CI 1.96-4.17) compared to NHW. Conclusions The incidence rate of B-cell ALL among adults in the US is higher among HW than other ethnic groups. Survival is significantly poorer among AA and HW than among NHW under the age of 40 with B-cell ALL. Survival is also significantly poorer among AA, HW and API than among NHW with T-cell ALL in adults under 40. Survival trends appear to converge after the age of 40 among all racial/ethnic groups. Disclosures No relevant conflicts of interest to declare.

scholarly journals Changes in the Incidence of Endstage Renal Disease Due to Lupus Nephritis in the United States, 1996–2004

2009 ◽  
Vol 36 (1) ◽  
pp. 63-67 ◽  
Author(s):  
MICHAEL M. WARD
Keyword(s):  
United States ◽  
Lupus Nephritis ◽  
Renal Disease ◽  
The United States ◽  
Population Based ◽  
Incidence Rates ◽  
Endstage Renal Disease ◽  
The Us ◽  
Population Based Registry ◽  
Us Census

ObjectiveTo determine if the incidence of endstage renal disease (ESRD) due to lupus nephritis has decreased from 1996 to 2004.MethodsPatients age 15 years or older with incident ESRD due to lupus nephritis in 1996–2004 and living in one of the 50 United States or the District of Columbia were identified using the US Renal Data System, a national population-based registry of all patients receiving renal replacement therapy for ESRD. Incidence rates were computed for each calendar year, using population estimates of the US census as denominators.ResultsOver the 9-year study period, 9199 new cases of ESRD due to lupus nephritis were observed. Incidence rates, adjusted to the age, sex, and race composition of the US population in 2000, were 4.4 per million in 1996 and 4.9 per million in 2004. Compared to the pooled incidence rate in 1996–1998, the relative risk of ESRD due to lupus nephritis in 1999–2000 was 0.99 (95% CI 0.93–1.06), in 2001–2002 was 0.99 (95% CI 0.92–1.06), and in 2003–2004 was 0.96 (95% CI 0.89–1.02). Findings were similar in analyses stratified by sex, age group, race, and socioeconomic status.ConclusionThere was no decrease in the incidence of ESRD due to lupus nephritis between 1996 and 2004. This may reflect the limits of effectiveness of current treatments, or limitations in access, use, or adherence to treatment.

scholarly journals Effects of climate changes and road exposure on the rapidly rising legionellosis incidence rates in the United States

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0250364
Author(s):  
Xiang Y. Han
Keyword(s):  
United States ◽  
Inverse Correlation ◽  
The United States ◽  
Incidence Rates ◽  
Ultraviolet B ◽  
Uvb Radiation ◽  
Climate Anomalies ◽  
Temperature And Precipitation ◽  
The Us ◽  
Rising Incidence

Legionellosis is an infection acquired through inhalation of aerosols that are contaminated with environmental bacteria Legionella spp. The bacteria require warm temperature for proliferation in bodies of water and moist soil. The legionellosis incidence in the United States has been rising rapidly in the past two decades without a clear explanation. In the meantime, the US has recorded consecutive years of above-norm temperature since 1997 and precipitation surplus since 2008. The present study analyzed the legionellosis incidence in the US during the 20-year period of 1999 to 2018 and correlated with concurrent temperature, precipitation, solar ultraviolet B (UVB) radiation, and vehicle mileage data. The age-adjusted legionellosis incidence rates rose exponentially from 0.40/100,000 in 1999 (with 1108 cases) to 2.69/100,000 in 2018 (with 9933 cases) at a calculated annual increase of 110%. In regression analyses, the rise correlated with an increase in vehicle miles driven and with temperature and precipitation levels that have been above the 1901–2000 mean since 1997 and 2008, respectively, suggesting more road exposure to traffic-generated aerosols and promotive effects of anomalous climate. Remarkably, the regressions with cumulative anomalies of temperature and precipitation were robust (R2 ≥ 0.9145, P ≤ 4.7E-11), implying possible changes to microbial ecology in the terrestrial and aquatic environments. An interactive synergy between annual precipitation and vehicle miles was also found in multiple regressions. Meanwhile, the bactericidal UVB radiation has been decreasing, which also contributed to the rising incidence in an inverse correlation. The 2018 legionellosis incidence peak corresponded to cumulative effects of the climate anomalies, vast vehicle miles (3,240 billion miles, 15904 km per capita), record high precipitation (880.1 mm), near record low UVB radiation (7488 kJ/m2), and continued above-norm temperature (11.96°C). These effects were examined and demonstrated in California, Florida, New Jersey, Ohio, and Wisconsin, states that represent diverse incidence rates and climates. The incidence and above-norm temperature both rose most in cold Wisconsin. These results suggest that warming temperature and precipitation surplus have likely elevated the density of Legionella bacteria in the environment, and together with road exposure explain the rapidly rising incidence of legionellosis in the United States. These trends are expected to continue, warranting further research and efforts to prevent infection.

scholarly journals Hypertension Control in the United States 2009 to 2018: Factors Underlying Falling Control Rates During 2015 to 2018 Across Age- and Race-Ethnicity Groups

Hypertension ◽  
2021 ◽  
Author(s):  
Brent M. Egan ◽  
Jiexiang Li ◽  
Susan E. Sutherland ◽  
Michael K. Rakotz ◽  
Gregory D. Wozniak
Keyword(s):  
United States ◽  
Blood Pressure ◽  
Health Care ◽  
Access To Care ◽  
Odds Ratio ◽  
Treatment Effectiveness ◽  
The United States ◽  
Hypertension Control ◽  
Race Ethnicity ◽  
Hispanic White

Hypertension control (United States) increased from 1999 to 2000 to 2009 to 2010, plateaued during 2009 to 2014, then fell during 2015 to 2018. We sought explanatory factors for declining hypertension control and assessed whether specific age (18–39, 40–59, ≥60 years) or race-ethnicity groups (Non-Hispanic White, NH [B]lack, Hispanic) were disproportionately impacted. Adults with hypertension in National Health and Nutrition Examination Surveys during the plateau (2009–2014) and decline (2015–2018) in hypertension control were studied. Definitions: hypertension, blood pressure (mm Hg) ≥140 and/or ≥90 mm Hg or self-reported antihypertensive medications (Treated); Aware, ‘Yes” to, “Have you been told you have hypertension?”; Treatment effectiveness, proportion of treated adults controlled; control, blood pressure <140/<90. Comparing 2009 to 2014 to 2015 to 2018, blood pressure control fell among all adults (−7.5% absolute, P <0.001). Hypertension awareness (−3.4%, P =0.01), treatment (−4.6%, P =0.004), and treatment effectiveness (−6.0%, P <0.0001) fell, despite unchanged access to care (health care insurance, source, and visits [−0.2%, P =0.97]). Antihypertensive monotherapy rose (+4.2%, P =0.04), although treatment resistance factors increased (obesity +4.0%, P =0.02, diabetes +2.3%, P =0.02). Hypertension control fell across age (18–39 [−4.9%, P =0.30]; 40–59 [−9.9%, P =0.0003]; ≥60 years [−6.5%, P =0.005]) and race-ethnicity groups (Non-Hispanic White [−8.5%, P =0.0007]; NHB −7.4%, P =0.002]; Hispanic [−5.2%, P =0.06]). Racial/ethnic disparities in hypertension control versus Non-Hispanic White were attenuated after adjusting for modifiable factors including education, obesity and access to care; NHB (odds ratio, 0.79 unadjusted versus 0.84 adjusted); Hispanic (odds ratio 0.74 unadjusted versus 0.98 adjusted). Improving hypertension control and reducing disparities require greater and more equitable access to high quality health care and healthier lifestyles.

scholarly journals Cervical Cancer Incidence Rates in Texas Counties 1995–2015

2019 ◽  
Vol 1 (1) ◽  
Author(s):  
Nicholas Salas
Keyword(s):  
United States ◽  
Cervical Cancer ◽  
Spatial Distribution ◽  
Cancer Incidence ◽  
The United States ◽  
Incidence Rates ◽  
The Political ◽  
Cervical Cancer Incidence ◽  
Race Ethnicity ◽  
Cancer Incidence Rates

As of 2014, Texas has the 6th highest incidence rate and the 5th highest mortality rate of cervical cancer in the nation. In addition, Texas ranks 3rd to last in the United States in human papilloma (HPV) vaccinations, which helps prevent one of the leading causes of cervical cancer. Cervical cancer incidence rates in Texas remain high, despite it becoming one the most successfully preventable treatable cancers in the United States due to a combination of screenings and HPV vaccinations. Furthermore, spatial distribution of cervical cancer is unknown among Texas counties. This study will follow the political ecology model to elaborate on the political, historical, social, and economic factors that may explain why HPV vaccinations are low and the incidence rate remains high despite the interventions available to people in Texas. This study will examine the geography of cervical cancer in Texas counties from 1995 - 2015 as well as its relationship with religious adherence, socioeconomic status, race/ethnicity, and uninsured rates. I will use a bivariate correlation to relate these factors with cancer incidence rates and ArcMap to create maps to illustrate the spatial distribution of these diseases. The data will be obtained from the Texas Cancer Registry, Texas County Health Rankings 2018, and the Association of Religion Data (CDC) Archives (ARDA). I expect that cervical cancer rates will decline after the introduction of the HPV vaccine in 2007, but areas with higher religious adherence will have higher rates of cervical cancer. In addition, I expect that uninsured rates, race/ethnicity, and socioeconomic factors could possibly impact cervical cancer incidence rates.

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