title: The Effect of Country of Birth on the Pattern of Disease and Survival From Cervical Cancer.
abstract: OBJECTIVE
  The aim of the study was to investigate the impact of country of birth on the pattern of disease and survival from cervical cancer in women living in the United Kingdom.
  
  
  METHODS
  A retrospective database evaluation study was performed to review all cases of cervical cancer diagnosed in the Pan-Birmingham Cancer Network between 2005 and 2009. Population characteristics and survival data were obtained from the West Midlands Cancer Registry and National Health Authority Information System, United Kingdom. Women's country of birth was classified as being high- (including patients born in the United Kingdom and Ireland), middle-, or low-income countries according to the World Bank country classification. Screening histories data were obtained from the West Midlands Cancer Screening Quality Assurance Reference Centre. Overall survival data were analyzed using the nonparametric Kaplan-Meier method with log-rank tests to compare between groups.
  
  
  RESULTS
  Four hundred eighty-four cases were identified. A country of birth was available for 459 cases (94.8%). Cancers detected through screening or interval cancers accounted for 140 (28.9%) of cases compared with 226 (46.7%) where women had not complied with screening. Of the women born outside of the United Kingdom/Ireland, 40 (59.7%) originated from low-income, 23 (34.3%) from middle-income, and 4 (6.0%) from high-income countries. Multivariate analysis identified age (p < .001) and stage (p < .001) at diagnosis as having a significant effect on survival, but no effect was seen from social deprivation (p = .18) or economic status of country of birth (p = .30).
  
  
  CONCLUSIONS
  Country of birth is not an independent prognostic indicator for cervical cancer survival.
authors.affiliation: 1West Midlands Cancer Screening QA Reference Centre, Public Health England, Birmingham; 2Department of Cancer Studies, Clinical Sciences Building, University of Leicester, Leicester Royal Infirmary, Leicester, Leicestershire; and 3Pan-Birmingham Gynaecological Cancer Centre, City Hospital, Birmingham, UK.
authors.forename: Esther
authors.initials: E
authors.lastname: Moss
authors.forename: Sarah
authors.initials: S
authors.lastname: Askew
authors.forename: Shan
authors.initials: S
authors.lastname: Cheung
authors.forename: Philip
authors.initials: P
authors.lastname: Dawson
authors.forename: Kavita
authors.initials: K
authors.lastname: Singh
authors.forename: Charles W E
authors.initials: CW
authors.lastname: Redman
authors.forename: Philippa
authors.initials: P
authors.lastname: Pearmain
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008875:Middle Aged; D012111:Residence Characteristics; D012189:Retrospective Studies; D016019:Survival Analysis; D006113:United Kingdom / Q000453:epidemiology; D002583:Uterine Cervical Neoplasms / Q000453:epidemiology* / Q000401:mortality*; D055815:Young Adult