title: Racial disparities in cervical cancer mortality in an African American and European American cohort in South Carolina.
abstract: South Carolina (SC) has some of the largest health disparities in the nation, in particular cancer mortality rates that disfavor African Americans (AA) in comparison to European Americans (EA) with 37% higher incidence and 61% higher mortality rates for AA women compared to EA women. Consequently, the purpose of this investigation was to examine and compare the impact of race on survival among cervical cancer patients in SC. Data from the SC Central Cancer Registry on all AA and EA cervical cancer patients in SC were analyzed for this investigation. All women greater than 19 years of age with a histopathologically-confirmed cervical neoplasm were included. Kaplan Meier survival curves were calculated and compared for each racial group using the log rank test statistic. Significant differences between races were noted for alcohol use, grade, histology, marital status, and vital status. AA women with cervical cancer had significantly decreased survival compared to EA women (49% vs. 66%, p < 0.01). This same trend was noted for all grade, histology, and stage types. We found significantly decreased survival among AA women with cervical cancer compared to EA women, which persisted even among AA and EA women with the same disease stage, grade, or histology. The causes of these disparities are most likely multi-faceted and interdependent. These findings emphasize the need for intervention into the myriad of factors ranging from the biological and genetic to the environmental and structural barriers impacting cervical cancer mortality.
authors.affiliation: USC, 915 Green Street, Room 244, Columbia, SC 29208, USA. swann.adams@sc.edu
authors.forename: Swann Arp
authors.initials: SA
authors.lastname: Adams
authors.forename: Alexandria
authors.initials: A
authors.lastname: Fleming
authors.forename: Heather M
authors.initials: HM
authors.lastname: Brandt
authors.forename: Deborah
authors.initials: D
authors.lastname: Hurley
authors.forename: Susan
authors.initials: S
authors.lastname: Bolick-Aldrich
authors.forename: Sharon M
authors.initials: SM
authors.lastname: Bond
authors.forename: James R
authors.initials: JR
authors.lastname: Hebert
mesh_terms: D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D000368:Aged; D016009:Chi-Square Distribution; D003710:Demography; D005260:Female; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D009367:Neoplasm Staging; D012042:Registries; D012959:Socioeconomic Factors; D013022:South Carolina / Q000453:epidemiology; D015996:Survival Rate; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology / Q000208:ethnology* / Q000401:mortality* / Q000473:pathology; D044465:White People / Q000706:statistics & numerical data*