title: Disparities in cervical cancer mortality rates as determined by the longitudinal hyperbolastic mixed-effects type II model.
abstract: BACKGROUND
  The main purpose of this study was to model and analyze the dynamics of cervical cancer mortality rates for African American (Black) and White women residing in 13 states located in the eastern half of the United States of America from 1975 through 2010.
  
  
  METHODS
  The cervical cancer mortality rates of the Surveillance, Epidemiology, and End Results (SEER) were used to model and analyze the dynamics of cervical cancer mortality. A longitudinal hyperbolastic mixed-effects type II model was used to model the cervical cancer mortality data and SAS PROC NLMIXED and Mathematica were utilized to perform the computations.
  
  
  RESULTS
  Despite decreasing trends in cervical cancer mortality rates for both races, racial disparities in mortality rates still exist. In all 13 states, Black women had higher mortality rates at all times. The degree of disparities and pace of decline in mortality rates over time differed among these states. Determining the paces of decline over 36 years showed that Tennessee had the most rapid decline in cervical cancer mortality for Black women, and Mississippi had the most rapid decline for White Women. In contrast, slow declines in cervical cancer mortality were noted for Black women in Florida and for White women in Maryland.
  
  
  CONCLUSIONS
  In all 13 states, cervical cancer mortality rates for both racial groups have fallen. Disparities in the pace of decline in mortality rates in these states may be due to differences in the rates of screening for cervical cancers. Of note, the gap in cervical cancer mortality rates between Black women and White women is narrowing.
authors.affiliation: School of Graduate Studies and Research, Meharry Medical College, Nashville, Tennessee, United States of America.
authors.forename: Mohammad A
authors.initials: MA
authors.lastname: Tabatabai
authors.affiliation: Department of Mathematics, Cameron University, Lawton, Oklahoma, United States of America.
authors.forename: Jean-Jacques
authors.initials: JJ
authors.lastname: Kengwoung-Keumo
authors.affiliation: Department of Mathematics, New Jersey City University, Jersey City, New Jersey, United States of America.
authors.forename: Wayne M
authors.initials: WM
authors.lastname: Eby
authors.affiliation: Division of Preventive Medicine and Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, Alabama, United States of America.
authors.forename: Sejong
authors.initials: S
authors.lastname: Bae
authors.affiliation: Department of Economics, University of New Mexico, Albuquerque, New Mexico, United States of America.
authors.forename: Juliette T
authors.initials: JT
authors.lastname: Guemmegne
authors.affiliation: Department of Pathology and Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, Alabama, United States of America.
authors.forename: Upender
authors.initials: U
authors.lastname: Manne
authors.affiliation: Division of Preventive Medicine and Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, Alabama, United States of America.
authors.forename: Mona
authors.initials: M
authors.lastname: Fouad
authors.affiliation: Department of Obstetrics & Gynecology and Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, Alabama, United States of America.
authors.forename: Edward E
authors.initials: EE
authors.lastname: Partridge
authors.affiliation: Division of Preventive Medicine and Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, Alabama, United States of America.
authors.forename: Karan P
authors.initials: KP
authors.lastname: Singh
mesh_terms: D001741:Black or African American; D000465:Algorithms; D001061:Appalachian Region / Q000453:epidemiology / Q000208:ethnology; D005260:Female; D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D015233:Models, Statistical; D009026:Mortality; D018426:SEER Program; D015144:Southeastern United States / Q000453:epidemiology / Q000208:ethnology; D013781:Texas / Q000453:epidemiology / Q000208:ethnology; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology* / Q000266:history / Q000401:mortality; D044465:White People