title: Impact of socioeconomic status and ethnic enclave on cervical cancer incidence among Hispanics and Asians in California.
abstract: OBJECTIVE
  This study aimed to evaluate the incidence of cervical cancer by nativity [United States (US) versus non-US], neighborhood socioeconomic status and ethnic enclave among Hispanics and Asians in California.
  
  
  METHODS
  Using data from the California Cancer Registry, information on all primary invasive cervical cancer (Cca) patients diagnosed in California from January 1, 1990 through December 31, 2004 was obtained. We analyzed the influence of enclave, socioeconomic status and nativity on Cca incidence.
  
  
  RESULTS
  Among the 22,189 Cca cases diagnosed between 1990 and 2004, 50% were non-Hispanic white, 39% Hispanic and 11% Asian women, and 63% US-born. Seventy percent of the Cca cases were squamous cell carcinoma, 19% adenocarcinoma and 11% other histologies. Higher incidence of Cca was observed in high enclave (76%) and low socioeconomic status (70%) neighborhoods. By ethnic group, US-born women showed lower rates of squamous cell carcinoma compared to foreign-born women. Hispanics living in low socioeconomic and high enclave had 12.7 times higher rate of Cca than those living in high socioeconomic, low enclave neighborhoods. For Asian women incidence rates were 6 times higher in the low socioeconomic, high enclave neighborhoods compared to those living in high socioeconomic, low enclave neighborhoods.
  
  
  CONCLUSIONS
  More targeted outreach to increase Pap smear screening and human papilloma virus vaccination for women living in high enclave neighborhoods can help decrease the incidence of Cca in these groups of women.
authors.affiliation: Department of Radiation Oncology, Stanford University Medical Center, Stanford, CA, USA. Electronic address: Marie-Anne.Froment@mail.chuq.qc.ca.
authors.forename: Marie-Anne
authors.initials: MA
authors.lastname: Froment
authors.affiliation: Cancer Prevention Institute of California, Fremont, CA, USA; Department of Health Research and Policy, School of Medicine, Stanford, CA, USA.
authors.forename: Scarlett L
authors.initials: SL
authors.lastname: Gomez
authors.affiliation: Department of Radiation Oncology, Hôpital Maisonneuve-Rosemont, Montreal, QC, Canada.
authors.forename: Audrey
authors.initials: A
authors.lastname: Roux
authors.affiliation: Cancer Prevention Institute of California, Fremont, CA, USA.
authors.forename: Mindy C
authors.initials: MC
authors.lastname: DeRouen
authors.affiliation: Department of Radiation Oncology, Stanford University Medical Center, Stanford, CA, USA.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Kidd
mesh_terms: D000230:Adenocarcinoma / Q000453:epidemiology / Q000208:ethnology*; D000293:Adolescent; D000328:Adult; D001213:Asian / Q000706:statistics & numerical data*; D002140:California / Q000453:epidemiology; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology / Q000208:ethnology*; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D008875:Middle Aged; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D012923:Social Class; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology / Q000208:ethnology*; D044465:White People / Q000706:statistics & numerical data; D055815:Young Adult
keywords: Cervical cancer; Ethnicity; Incidence rate; Socioeconomic status