Racial and ethnic disparities in cervical cancer incidence rates in the United States, 1992-2003.
OBJECTIVE
Differences in cervical cancer incidence rates by race/ethnicity persist in the United States. We examined these differences by histologic type and by various patient and socioeconomic characteristics.


METHODS
Thirteen U.S. cancer registries were used to identify women 20-79 years of age diagnosed from 1992 to 2003 with invasive cervical cancer. Age-adjusted incidence rates and annual percent changes were calculated for four different races/ethnicities (Non-Hispanic whites, Hispanic whites, African-Americans, and Asians/Pacific Islanders) for cervical cancer overall, squamous cell carcinoma (SCC), and adenocarcinoma (AC).


RESULTS
Hispanic whites had the highest incidence rate of cervical cancer overall (24.2/100,000), SCC (18.3/100,000), and AC (4.6/100,000). Non-Hispanic whites had the lowest rates of cervical cancer overall (10.8/100,000) and SCC (7.2/100,000), while African-Americans had the lowest rate of AC (2.3/100,000). Incidence rates of cervical cancer overall and SCC declined across all racial/ethnic groups. Numerous variations in incidence rates and annual percent changes were observed when analyses were stratified by county level socioeconomic characteristics.


CONCLUSIONS
Variations in screening utilization and socioeconomic status may account for the majority of racial/ethnic disparities in cervical cancer incidence. Targeting groups with the greatest burdens of cervical cancer is of public health importance, particularly as we enter the human papillomavirus vaccine era.
McDougall
Jean A
JA
Fred Hutchinson Cancer Research Center, Division of Public Health Sciences, Cancer Epidemiology Research Cooperative Studies (M4-C308), Seattle, WA 98109-1024, USA. mcdouj@u.washington.edu
Madeleine
Margaret M
MM
Daling
Janet R
JR
Li
Christopher I
CI
D000230:Adenocarcinoma / Q000453:epidemiology / Q000208:ethnology* / Q000517:prevention & control; D000328:Adult; D001741:Black or African American; D000368:Aged; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D018307:Neoplasms, Squamous Cell / Q000453:epidemiology / Q000208:ethnology* / Q000517:prevention & control; D053918:Papillomavirus Vaccines / Q000627:therapeutic use; D012189:Retrospective Studies; D018426:SEER Program; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology / Q000208:ethnology* / Q000517:prevention & control; D044465:White People