title: Incidence of dysplasia and carcinoma of the uterine cervix in an Appalachian population.
abstract: BACKGROUND
  Cervical cancer mortality rates in the Appalachian population of southeastern Kentucky have been shown to be unusually high. To better understand the high cervical cancer death rate in this area, we developed a population-based cervical disease registry.
  
  
  OBJECTIVE
  This study describes the incidence of cervical dysplasia, carcinoma in situ, and invasive cervical cancer in 1986 and 1987 among White women in a 36-county area of Appalachian Kentucky based on histologic diagnoses.
  
  
  METHODS
  We compared average annual age-adjusted incidence rates for carcinoma in situ and invasive cervical cancer in the study area with those for women in the Surveillance, Epidemiology, and End Results (SEER) Program.
  
  
  RESULTS
  The incidence rate of invasive cervical cancer for women in the study area (14.9 per 100,000) was nearly twice that for White women in the SEER population (7.8 per 100,000), but it was similar to that for Black women in the SEER population (15.3 per 100,000). The incidence of carcinoma in situ for women in the study population (38.2 per 100,000) was 21% higher than that for White women (31.5 per 100,000) or for Black women (31.2 per 100,000) in the SEER population. The average annual age-adjusted incidence rate for all grades of dysplasia among women in the study population was 194.6 per 100,000. No comparable population-based incidence rates for dysplasia could be identified.
  
  
  CONCLUSIONS
  Cervical cancer incidence rates are higher in Appalachian Kentucky than in the SEER population. Poverty appears to be a factor associated with these rates.
  
  
  CONCLUSIONS
  Low-density populations such as those in rural Appalachia deserve greater attention in cancer control research. The population-based cervical dysplasia rates reported here may be useful for comparisons in future investigations.
authors.affiliation: Cancer Control Division, Lucille Parker Markey Cancer Center, University of Kentucky, Lexington 40536-0093.
authors.forename: G H
authors.initials: GH
authors.lastname: Friedell
authors.forename: T C
authors.initials: TC
authors.lastname: Tucker
authors.forename: E
authors.initials: E
authors.lastname: McManmon
authors.forename: M
authors.initials: M
authors.lastname: Moser
authors.forename: C
authors.initials: C
authors.lastname: Hernandez
authors.forename: M
authors.initials: M
authors.lastname: Nadel
mesh_terms: D001061:Appalachian Region / Q000453:epidemiology; D002278:Carcinoma in Situ / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D007629:Kentucky / Q000453:epidemiology; D009361:Neoplasm Invasiveness; D011159:Population Surveillance; D011203:Poverty; D012423:Rural Health; D002578:Uterine Cervical Dysplasia / Q000453:epidemiology*; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology*