title: An examination of racial differences in 5-year survival of cervical cancer among African American and white American women in the southeastern US from 1985 to 2010.
abstract: Disparities in Cervical Cancer (CC) mortality outcomes between African American (AA) and White women have been studied for decades. However, conclusions about the effect of race on CC survival differ across studies. This study assessed differences in CC survival between AA and White women diagnosed between 1985 and 2010 and treated at two major hospitals in the southeastern US. The study sample included 925 AA and 1192 White women diagnosed with cervical adenocarcinoma, adenosquamous cell carcinoma, or squamous cell carcinoma. Propensity score adjustment and matching were employed to compare 5-year survival between the two racial groups. Crude comparisons suggested relevant racial differences in survival. However, the racial differences became of small magnitude after propensity-score adjustment and in matched analyses. Nonlinear models identified age at diagnosis, cancer stage, mode of treatment, and histological subtype as the most salient characteristics predicting 5-year survival of CC, yet these characteristics were also associated with race. Crude racial differences in survival might be partly explained by underlying differences in the characteristics of racial groups, such as age at diagnosis, histological subtype, cancer stage, and the mode of treatment. The study results highlight the need to improve access to early screening and treatment opportunities for AA women to improve posttreatment survival from CC.
authors.affiliation: University of Alabama at Birmingham, Department of Nutrition Sciences, Birmingham, Alabama.
authors.forename: Janaka
authors.initials: J
authors.lastname: Weragoda
authors.affiliation: University of Alabama at Birmingham, Department of Family, Community & Health Systems, Birmingham, Alabama.
authors.forename: Andres
authors.initials: A
authors.lastname: Azuero
authors.affiliation: University of Alabama at Birmingham, Department of Nutrition Sciences, Birmingham, Alabama.
authors.forename: Suguna
authors.initials: S
authors.lastname: Badiga
authors.affiliation: University of Alabama at Birmingham, Department of Pathology, Birmingham, Alabama.
authors.forename: Walter C
authors.initials: WC
authors.lastname: Bell
authors.affiliation: Morehouse School of Medicine, Department of Obstetrics and Gynecology, Atlanta, Georgia.
authors.forename: Roland
authors.initials: R
authors.lastname: Matthews
authors.affiliation: University of Alabama at Birmingham, Department of Nutrition Sciences, Birmingham, Alabama.
authors.forename: Chandrika
authors.initials: C
authors.lastname: Piyathilake
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D049673:History, 20th Century; D049674:History, 21st Century; D006801:Humans; D008875:Middle Aged; D015144:Southeastern United States / Q000453:epidemiology / Q000208:ethnology; D016019:Survival Analysis; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000266:history / Q000401:mortality* / Q000628:therapy; D044465:White People / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: Cervical cancer; racial disparities; survival; survival analysis