Cervical cancer incidence, mortality, and survival among Asian subgroups in California, 1990-2004.
BACKGROUND
Aggregated cancer statistics for Asians mask important differences in cancer burden among Asian subgroups. The purpose of this study was to describe the relative patterns of cervical cancer incidence, mortality, and survival among Chinese, Filipino, Japanese, Korean, South Asian, and Vietnamese women in California, using data from the California Cancer Registry.


METHODS
All cervical cancer cases diagnosed among the 6 subgroups and non-Hispanic whites (NHW) from 1990 to 2004 were identified and used to calculate incidence and mortality rates and trends. The Kaplan-Meier method was used to calculate 5- and 10-year survival probabilities by subgroup, and Cox proportional hazards methodology was used to calculate survival differences adjusted for race and ethnicity, age, stage at diagnosis, socioeconomic status, and treatment factors.


RESULTS
Vietnamese and Korean women experienced greater cervical cancer incidence and mortality than NHW women, whereas rates among Chinese, Japanese, and South Asians were comparable or lower. Five-year unadjusted survival probabilities were greatest for South Asians (86%) and Koreans (86%), followed by Vietnamese (82%), Chinese (79%), and Filipinos (79%), as compared with NHW (78%) and Japanese (72%). The adjusted risk of cervical cancer death was significantly lower for South Asians, Koreans, Vietnamese, and Filipinos than for NHW women, but not for Chinese and Japanese.


CONCLUSIONS
Cervical cancer incidence rates vary substantially across the major Asian subgroups. Despite higher incidence and mortality rates compared with NHW women, Vietnamese, Koreans, and Filipinos have better survival outcomes. Further studies are needed to examine the factors behind these survival differences.
Bates
Janet H
JH
Public Health Institute, California Cancer Registry, Sacramento, California 95825, USA. jbates@ccr.ca.gov
Hofer
Brenda M
BM
Parikh-Patel
Arti
A
D000230:Adenocarcinoma / Q000453:epidemiology* / Q000208:ethnology / Q000401:mortality; D000328:Adult; D000368:Aged; D001213:Asian / Q000706:statistics & numerical data*; D002140:California / Q000453:epidemiology; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology / Q000208:ethnology / Q000401:mortality; D005260:Female; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D012042:Registries; D012923:Social Class; D016019:Survival Analysis; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology* / Q000208:ethnology / Q000401:mortality