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.
Coker
Ann L
AL
Department of Obstetrics and Gynecology, Center for Research on Violence Against Women, University of Kentucky, Lexington, Kentucky 40536-0293, USA. ann.coker@uky.edu
Desimone
Christopher P
CP
Eggleston
Katherine S
KS
White
Arica L
AL
Williams
Melanie
M
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