A population-based study of racial and ethnic differences in survival among women with invasive cervical cancer: analysis of Surveillance, Epidemiology, and End Results data.
OBJECTIVE
The incidence of cervical cancer is higher in Hispanic than in non-Hispanic or African American women in the United States, but few studies have examined differences in survival between these groups. The objective of this study was to examine racial/ethnic differences in survival after diagnosis with invasive cervical cancer in a population-based sample of patients while adjusting for patient and tumor characteristics and treatment types.


METHODS
We identified 7267 women (4431 non-Hispanic Caucasians, 1830 Hispanic Caucasians, and 1006 non-Hispanic African Americans) diagnosed with primary invasive cervical cancer from 1992 to 1996 (with follow-up through 2000) from the Surveillance, Epidemiology and End Results (SEER) Program. Kaplan-Meier and Cox proportional hazards survival methods were used to assess differences in survival by race/ethnicity.


RESULTS
After adjusting for age at diagnosis, histology, stage, first course of cancer-directed treatment (surgery and radiation therapy), and SEER registry, Hispanic Caucasian women were at 26% decreased risk of death from any cause (hazard ratio (HR) = 0.74, 95% confidence interval (CI): 0.66-0.83) and non-Hispanic African American women were at 19% increased risk of death (HR = 1.19, 95% CI: 1.06-1.33) compared to non-Hispanic Caucasian women over the follow-up period.


CONCLUSIONS
Analysis of population-based SEER data indicates significant survival differences by race/ethnicity for women with invasive cervical cancer. Hispanic Caucasian women in SEER had improved survival compared to non-Hispanic Caucasian or non-Hispanic African American women.
Patel
Divya A
DA
Wayne State University School of Medicine and Karmanos Cancer Institute, Detroit, MI 48201, USA. divya@med.umich.edu
Barnholtz-Sloan
Jill S
JS
Patel
Mehul K
MK
Malone
John M
JM
Chuba
Paul J
PJ
Schwartz
Kendra
K
D000328:Adult; D001741:Black or African American; D000368:Aged; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D018426:SEER Program; D015996:Survival Rate; D014481:United States / Q000453:epidemiology; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology* / Q000208:ethnology* / Q000401:mortality; D044465:White People