title: Black and white women in Maryland receive different treatment for cervical cancer.
abstract: OBJECTIVE
  Despite an overall decrease in incidence, the death rate from cervical cancer in the United States remains higher in black women than their white counterparts. We examined the Maryland Cancer Registry (MCR) to determine treatment factors that may explain differences in outcomes between races in the state of Maryland.
  
  
  METHODS
  Incident cervical cancers in the MCR 1992-2008 were examined. Demographics, tumor characteristics and treatments were compared between races and over time.
  
  
  RESULTS
  Our analysis included 2034 (1301 white, 733 black) patients. Black women were more likely to have locally advanced or metastatic disease at diagnosis (p<0.01). They were more likely to receive any radiation or chemotherapy combined with radiation and less likely to receive surgery (p<0.01). When adjusted for stage and insurance status black women had 1.50 (95% CI 1.20-1.87) times the odds of receiving radiation and 1.43 (95% CI 1.11-1.82) times the odds of receiving chemotherapy. Black women with cervical cancer had 0.51 times the adjusted odds (95% CI 0.41-0.65) of receiving surgery compared to white women. Racial differences in treatment did not change significantly over time.
  
  
  CONCLUSIONS
  Surgical treatment for newly diagnosed cervical cancer in the state of Maryland was significantly less common amongst black women than white during our study period. Equivalent treatments are not being administered to white and black patients with cervical cancer in Maryland. Differences in care may contribute to racial disparities in outcomes for women with cervical cancer.
authors.affiliation: University of Maryland School of Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, Baltimore, Maryland, United States of America.
authors.forename: Saroj
authors.initials: S
authors.lastname: Fleming
authors.affiliation: University of Maryland School of Medicine, Department of Epidemiology and Public Health, Baltimore, Maryland, United States of America.
authors.forename: Nicholas H
authors.initials: NH
authors.lastname: Schluterman
authors.affiliation: University of Maryland School of Medicine, Department of Epidemiology and Public Health, Baltimore, Maryland, United States of America.
authors.forename: J Katthleen
authors.initials: JK
authors.lastname: Tracy
authors.affiliation: University of Maryland School of Medicine, Department of Obstetrics, Gynecology and Reproductive Sciences, Baltimore, Maryland, United States of America.
authors.forename: Sarah M
authors.initials: SM
authors.lastname: Temkin
mesh_terms: D001741:Black or African American; D005260:Female; D006801:Humans; D015994:Incidence; D008396:Maryland / Q000453:epidemiology; D008875:Middle Aged; D009362:Neoplasm Metastasis / Q000473:pathology / Q000628:therapy; D009367:Neoplasm Staging / Q000379:methods; D012189:Retrospective Studies; D018426:SEER Program; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology / Q000473:pathology* / Q000628:therapy*; D044465:White People; D014930:Women