title: Age-specific trends in black-white disparities in cervical cancer incidence in the United States: 1975-2009.
abstract: BACKGROUND
  Although overall cervical cancer incidence rates have decreased in both black and white women in the U.S. since the mid 1950s due to widespread screening, rates continue to be higher among blacks than among whites. However, whether this pattern differs by age is unknown.
  
  
  METHODS
  Cervical cancer cases (1975-2009, N=36,503) were obtained from nine Surveillance, Epidemiology, and End Results (SEER) Program registries. Age-standardized incidence rates for white and black women were calculated from 1975-1979 through 2005-2009 by age group (<50, 50-64, and ≥65 years). Rate ratios (RRs) and 95% confidence intervals (CIs) evaluated differences in rates for blacks vs. whites by age group and stage at diagnosis during 1975-1979 and 2005-2009.
  
  
  RESULTS
  Among women aged <50 years, the black-to-white disparity RR decreased from nearly two-fold (RR, 1.9; 95% CI, 1.7-2.1) during 1975-1979 to unity during 2005-2009 (RR, 0.9; 95% CI, 0.8-1.0). In contrast, rates remained significantly elevated for blacks vs. whites aged 50-64 years (RR, 2.4; 95% CI, 2.1-2.7 and 1.7; 95% CI, 1.5-2.0), and for those aged ≥65 years (RR, 3.3; 95% CI, 2.9-3.8 and 2.2; 95% CI, 1.9-2.7) during both time periods, although the disparities decreased over time. Similar disparities persisted for older black women with cervical cancer of all stages.
  
  
  CONCLUSIONS
  Disparities in cervical cancer incidence rates were eliminated for younger blacks vs. whites but persisted for blacks aged 50 years and older. Additional strategies are needed to increase follow-up and treatment of precancerous lesions among middle-aged and older black women.
authors.affiliation: Surveillance Research Program, American Cancer Society, Atlanta, GA 30303, USA. edgar.simard@cancer.org
authors.forename: Edgar P
authors.initials: EP
authors.lastname: Simard
authors.forename: Deepa
authors.initials: D
authors.lastname: Naishadham
authors.forename: Debbie
authors.initials: D
authors.lastname: Saslow
authors.forename: Ahmedin
authors.initials: A
authors.lastname: Jemal
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D044383:Black People / Q000706:statistics & numerical data*; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D013997:Time Factors; D014481:United States / Q000453:epidemiology; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology* / Q000208:ethnology*; D044465:White People / Q000706:statistics & numerical data*; D001741:Black or African American