title: Association of insurance status and age with cervical cancer stage at diagnosis: National Cancer Database, 2000-2007.
abstract: OBJECTIVE
  We examined the relationship of age at diagnosis and insurance status with stage among cervical cancer patients aged 21 to 85 years.
  
  
  METHODS
  We selected data on women (n = 69 739) diagnosed with invasive cervical cancer between 2000 and 2007 from the National Cancer Database. We evaluated the association between late stage (stage III/IV) and both insurance and age, with adjustment for race/ethnicity and other sociodemographic and clinical factors. We used multivariable log binomial models to estimate risk ratios (RRs) and 95% confidence intervals (CIs).
  
  
  RESULTS
  The proportion of late-stage disease increased with age: from 16.53% (21-34 years) to 42.44% (≥ 70 years). The adjusted relative risk of advanced-stage disease among women aged 50 years and older was 2.2 to 2.5 times that of patients aged 21 to 34 years. Uninsured (RR = 1.44; 95% CI = 1.40, 1.49), Medicaid (RR = 1.37, 95% CI = 1.34, 1.41), younger Medicare (RR = 1.12, 95% CI = 1.06, 1.19), and older Medicare (RR = 1.20, 95% CI = 1.15, 1.26) patients had a higher risk of late-stage disease than did privately insured patients.
  
  
  CONCLUSIONS
  Screening should be encouraged for women at high risk for advanced-stage disease.
authors: Department of Research, American Cancer Society, Atlanta, GA 30303, USA. stacey.fedewa@cancer.org
authors: Stacey A
authors: SA
authors: Fedewa
authors: Vilma
authors: V
authors: Cokkinides
authors: Katherine S
authors: KS
authors: Virgo
authors: Priti
authors: P
authors: Bandi
authors: Debbie
authors: D
authors: Saslow
authors: Elizabeth M
authors: EM
authors: Ward
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D005260:Female; D006306:Health Surveys; D006801:Humans; D007348:Insurance, Health / Q000706:statistics & numerical data*; D008484:Medicaid / Q000706:statistics & numerical data; D006278:Medicare / Q000706:statistics & numerical data; D008875:Middle Aged; D009367:Neoplasm Staging; D012042:Registries; D012306:Risk; D018426:SEER Program; D014481:United States; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000473:pathology*; D055815:Young Adult