Ethnic disparities in cervical cancer survival among Texas women.
OBJECTIVE
The aim of this work was to determine whether minority women are more likely to die of cervical cancer. A population-based cohort study was performed using Texas Cancer Registry (TCR) data from 1998 to 2002.


METHODS
A total of 5,166 women with cervical cancer were identified during 1998-2002 through the TCR. Measures of socioeconomic status (SES) and urbanization were created using census block group-level data. Multilevel logistic regression was used to calculate the odds of dying from cervical cancer by race, and Cox proportional hazards modeling was used for cervical cancer-specific survival analysis.


RESULTS
After adjusting for age, SES, urbanization, stage, cell type, and treatment, Hispanic women were significantly less likely than non-Hispanic White women to die from cervical cancer (adjusted hazard ratio [aHR] = 0.69; 95% CI [confidence interval] = 0.59-0.80), whereas Black women were more likely to die (aHR = 1.26; 95% CI = 1.06-1.50). Black and Hispanic women were more likely to be diagnosed at a later stage than White women. Black women were significantly less likely to receive surgery among those diagnosed with localized disease (p = 0.001) relative to both White and Hispanic women.


CONCLUSIONS
Relative to non-Hispanic White women, Black women were more likely to die of cervical cancer while Hispanic women were less likely to die; these survival differences were not explained by SES, urbanization, age, cell type, stage at diagnosis, or treatment.
Department of Obstetrics and Gynecology, Center for Research on Violence Against Women, University of Kentucky, Lexington, Kentucky 40536-0293, USA. ann.coker@uky.edu
Ann L
AL
Coker
Christopher P
CP
Desimone
Katherine S
KS
Eggleston
Arica L
AL
White
Melanie
M
Williams
D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D000368:Aged; D016001:Confidence Intervals; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D054624:Health Status Disparities; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D008875:Middle Aged; D016017:Odds Ratio; D016016:Proportional Hazards Models; D018570:Risk Assessment; D012959:Socioeconomic Factors; D017741:Survivors / Q000706:statistics & numerical data*; D013781:Texas / Q000453:epidemiology; D002583:Uterine Cervical Neoplasms / Q000208:ethnology* / Q000401:mortality* / Q000628:therapy; D044465:White People / Q000706:statistics & numerical data