Cervical cancer incidence in the United States in the US-Mexico border region, 1998-2003.
BACKGROUND
Cervical cancer mortality rates have declined in the United States, primarily because of Papanicolaou testing. However, limited information is available about the incidence of the disease in the US-Mexico border region, where some of the poorest counties in the United States are located. This study was undertaken to help compare the patterns of cervical cancer incidence among women in the US-Mexico border region and other parts of the United States.


METHODS
Age-adjusted cervical cancer incidence rates for border counties in the states bordering Mexico (California, Arizona, New Mexico, Texas) for the years 1998 to 2003 were compared with the rates for nonborder counties of the border states and with those of nonborder states. Differences were examined by age, race, ethnicity, rural residence, educational attainment, poverty, migration, stage of disease, and histology.


RESULTS
Overall, Hispanic women had almost twice the cervical cancer incidence of non-Hispanic women in border counties, and Hispanic women in the border states had higher rates than did non-Hispanic women in nonborder states. In contrast, cervical cancer incidence rates among black women in the border counties were lower than those among black women in the nonborder states. Among white women, however, incidence rates were higher among those in nonborder states. Differences in cervical cancer incidence rates by geographic locality were also evident by age, urban/rural residence, migration from outside the United States, and stage of disease.


CONCLUSIONS
Disparities in cervical cancer incidence in the US-Mexico border counties, when the incidence is compared with that of other counties and geographic regions, are evident. Of particular concern are the higher rates of late-stage cervical cancer diagnosed among women in the border states, especially because such cervical cancer is preventable.
Coughlin
Steven S
SS
Epidemiology and Applied Research Branch, Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia, USA. steven.coughlin@va.gov
Richards
Thomas B
TB
Nasseri
Kiumarss
K
Weiss
Nancy S
NS
Wiggins
Charles L
CL
Saraiya
Mona
M
Stinchcomb
David G
DG
Vensor
Veronica M
VM
Nielson
Carrie M
CM
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001130:Arizona / Q000453:epidemiology; D044383:Black People / Q000706:statistics & numerical data; D002140:California / Q000453:epidemiology; D002648:Child; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D015994:Incidence; D008800:Mexico; D008875:Middle Aged; D009516:New Mexico / Q000453:epidemiology; D013781:Texas / Q000453:epidemiology; D014481:United States / Q000453:epidemiology; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology* / Q000208:ethnology; D044465:White People / Q000706:statistics & numerical data; D001741:Black or African American