Rural–Urban and Racial/Ethnic Disparities in Invasive Cervical Cancer Incidence in the United States, 2010–2014

5605 Background: The incidence of cervical cancer in the United States has declined since the introduction of the pap smear. However, differences exist based on ethnicity and socioeconomic status (SES).This study aimed to evaluate the impact of nativity, neighborhood SES and enclave (degree of ethnic isolation) on the incidence of cervical cancer in California. Methods: Using data from the California Cancer Registry, comprising three of the National Cancer Institute’s Surveillance Epidemiology and End Results (SEER) program registries, information on all primary invasive cervical cancer diagnosed in California from January 1, 1990, through December 31, 2004 was obtained. We analyzed the influence of enclave, SES, and nativity on cervical cancer incidence. Results: Among the 22,189 invasive cervical cancer cases diagnosed between 1990 and 2004, 50% were non-Hispanic white (NHW), 39% Hispanic and 11% Asian women. Seventy percent (70%) of the invasive cervical cancer cases were squamous cell carcinoma (SCC), 19% were adenocarcinoma and 11% other histologies. Approximately half (51%) of patients presented with localized disease, 33% regional disease, 10% distant disease and 6% unknown. By ethnic group, US born women showed lower rates of SCC compared to foreign-born women. Seventy-six percent (76%) of invasive cervical cases were observed in high enclave neighborhoods, and seventy percent (70%) were noted in low SES neighborhoods. Hispanics living in low SES and high enclave had 12.7 times (95% CI; 11.2-14.3) higher rate of cervical cancer than those living in high SES, low enclave neighborhoods. For Asian women incidence rates were 6 times (95% CI; 4.9-7.5) higher in the low SES, high enclave neighborhoods compared to those living in high SES, low enclave neighborhoods. Conclusions: More efforts should be done to reach out to and increase pap smear screening for women living in high enclave neighborhoods to help decrease the incidence of invasive cervical cancer cases in these groups of women.

Download Full-text

Cervical Cancer Incidence Rates in Texas Counties 1995â€“2015

North Texas Journal of Undergraduate Research ◽

10.12794/journals.ntjur.v1i1.79 ◽

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.

Download Full-text