title: Incidence trends of invasive cervical cancer in the United States by combined race and ethnicity.
abstract: OBJECTIVE
  To better understand national patterns of invasive cervical cancer (ICC) incidence by race and ethnicity in order to develop appropriate ICC prevention policies.
  
  
  METHODS
  Age-adjusted and age-specific ICC incidence rates were calculated by combined race/ethnicity, making distinct the Hispanic/all races category from three other Non-Hispanic (White, Black and other) racial categories.
  
  
  RESULTS
  There was a significant downward trend in ICC incidence during both time periods for every combination of race/ethnicity (p-value <0.05) except Hispanic/all races during 1995-1999. Non-Hispanic/Black and Hispanic/all races women had significantly higher incidence rates of ICC compared to Non-Hispanic/White women. ICC incidence peaked much earlier for Non-Hispanic/White women (35-44 years of age) compared to any other racial/ethnic group. Non-Hispanic (White, Black and other) women had lower rates of adenocarcinoma and squamous cell carcinoma compared to Hispanic/all races women. Non-Hispanic/Black and Hispanic/all races women were more likely to be diagnosed at late stage or unstaged at diagnosis than Non-Hispanic/White women.
  
  
  CONCLUSIONS
  Although ICC incidence decreased significantly over the last 10 years, Black or Hispanic US populations continue to have the highest ICC incidence compared to Non-Hispanic/Whites, highlighting the need for improved health literacy and social support to ensure their equal access to ICC screening and HPV prevention including HPV vaccination.
authors.affiliation: Case Comprehensive Cancer Center, Case Western Reserve University School of Medicine, Cleveland, OH 44106-5065, USA. jsb42@case.edu
authors.forename: Jill
authors.initials: J
authors.lastname: Barnholtz-Sloan
authors.forename: Nitin
authors.initials: N
authors.lastname: Patel
authors.forename: Dana
authors.initials: D
authors.lastname: Rollison
authors.forename: Karl
authors.initials: K
authors.lastname: Kortepeter
authors.forename: Jill
authors.initials: J
authors.lastname: MacKinnon
authors.forename: Anna
authors.initials: A
authors.lastname: Giuliano
mesh_terms: D000230:Adenocarcinoma / Q000208:ethnology; D000293:Adolescent; D000328:Adult; D001741:Black or African American; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000208:ethnology; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D018426:SEER Program; D014481:United States / Q000208:ethnology; D002583:Uterine Cervical Neoplasms / Q000208:ethnology*; D044465:White People; D055815:Young Adult