Widening socioeconomic disparities in cervical cancer mortality among women in 26 states, 1993‐2007

Abstract

BACKGROUND: Despite substantial declines in cervical cancer mortality because of widespread screening, socioeconomic status (SES) disparities persist. The authors examined trends in cervical cancer mortality rates and the risk of late-stage diagnoses by SES. METHODS: Using data from the National Vital Statistics System, trends in age-standardized mortality rates among women ages 25 to 64 years (1993)(1994)(1995)(1996)(1997)(1998)(1999)(2000)(2001)(2002)(2003)(2004)(2005)(2006)(2007) by education level ( 12 years, 13-15 years, and !16 years) and race/ethnicity for non-Hispanic white (NHW) women and non-Hispanic black (NHB) women in 26 states were assessed using log-linear regression. Rate ratios (RRs) and 95% confidence intervals (CIs) were used to assess disparities between those with 12 years versus !16 years of education during 1993 to 1995 and 2005 to 2007. Avertable deaths were calculated by applying mortality rates from the most educated women to others in 48 states. Trends in the risk of late-stage diagnosis by race/ethnicity and insurance status were evaluated in the National Cancer Data Base. RESULTS: Declines in mortality were steepest for those with the highest education levels (3.2% per year among NHW women and 6.8% per year among NHB women). Consequently, the education disparity widened between the periods 1993 to 1995 and 2005 to 2007 from 3.1 (95% CI, 2.4-3.9) to 4.4 (95% CI, 3.5-5.6) for NHW women and from 3.8 (95% CI, 2.0-7.0) to 5.6 (95% CI, 3.1-10.0) for NHB women.

Differential uptake of recent Papanicolaou testing by HPV vaccination status among young women in the United States, 2008–2013

“…Furthermore, racial/ ethnic and SES disparities in cervical cancer incidence and mortality rates have been reported [32]. In our study population, regardless of vaccination status, the most affluent individuals were more likely to have health insurance and to have had a recent healthcare visit than those at lower income levels (x 2 pvalues < 0.05) [12] suggesting greater access to care.…”

Health Disparities between Black Hispanic and Black Non-Hispanic Cervical Cancer Cases in the USA

“…Interestingly, blacks experienced similar cervical cancer rates as Vietnamese and Koreans Wang et al, 2010). In addition, blacks reported the highest rates of late stage cervical cancer diagnosis (Simard et al, 2012).…”

“…Cervical cancer screenings are important because they result in early detection and early treatment of disease, however, there are differences among screening patterns of different ethnicities (Smith et al, 2011;Simard et al, 2012;Haile et al, 2012). Because of these disparities, it is imperative to assess the differences in cervical cancer survival across ethnicities.…”

“…There has been a consistent failure in reaching the most disadvantaged and at risk populations (Glick et al, 2012;Saslow et al, 2012;Simard et al, 2012). An increase in cervical cancer screening between the years 1993 and 2007 has resulted in a decline in cervical cancer related mortality.…”

Global Cancer Consortiums: Moving from Consensus to Practice

“…6 Socioeconomically disadvantaged people are less likely to visit a cancer specialist, they have a lower likelihood of undergoing appropriate state-of-the-art operative treatment of malignancy, they are less likely to receive indicated adjuvant therapy, and they have a 10 % lower overall survival across all cancer types even when adjusted for income level. 7,8 Although poverty and demographic factors have been known to contribute to worse cancer outcomes in high-resource countries for almost 30 years, significant disparities in access to quality cancer care persist.…”