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Racial disparities in cervical cancer survival over time
Author(s) -
RauhHain J. Alejandro,
Clemmer Joel T.,
Bradford Leslie S.,
Clark Rachel M.,
Growdon Whitfield B.,
Goodman Annekathryn,
Boruta David M.,
Schorge John O.,
Carmen Marcela G.
Publication year - 2013
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.28261
Subject(s) - medicine , hazard ratio , confidence interval , cervical cancer , proportional hazards model , epidemiology , marital status , cancer registry , cancer , demography , gynecology , population , environmental health , sociology
BACKGROUND The purpose of this study is to examine changes over time in survival for African American (AA) and white women diagnosed with cervical cancer (CC). METHODS Surveillance, Epidemiology, and End Results (SEER) Program data from 1985 to 2009 were used for this analysis. Racial differences in survival were evaluated between African American (AA) and white women. Kaplan‐Meier and Cox proportional hazards survival methods were used to assess differences in survival by race at 5‐year intervals. RESULTS The study sample included 23,368 women, including 3886 (16.6%) who were AA and 19,482 (83.4%) who were white. AA women were older (51.4 versus 48.9 years; P < .001) and had a higher rate of regional (38.3% versus 31.8%; P < .001) and distant metastasis (10.7% versus 8.7%; P < .001). AA less frequently received cancer‐directed surgery (32.4% versus 46%; P < .001), and more frequently radiotherapy (36.3% versus 26.4%; P < .001). Overall, AA women had a hazard ratio (HR) of 1.41 (95% confidence interval = 1.32‐1.51) of cervical cancer (CC) mortality compared with whites. Adjusting for SEER registry, marital status, stage, age, treatment, grade, and histology, AA women had an HR of 1.13 (95% confidence interval = 1.05‐1.22) of CC‐related mortality. After adjusting for the same variables, there was a significant difference in CC‐specific mortality between 1985 to 1989 and 1990 to 1994, but not after 1995. CONCLUSIONS After adjusting for race, SEER registry, marital status, stage, age, treatment, grade, and histology, there was a significant difference in CC‐specific mortality between 1985 to 1989 and 1990 to 1994, but not after 1995. Cancer 2013;119:3644–3652 . © 2013 American Cancer Society .