Disparities in Cervical Cancer Characteristics and Survival Between White Hispanics and White Non-Hispanic Women.
BACKGROUND
Cervical cancer is the second most common cancer among women resulting in nearly 500,000 cases annually. Screening leads to better treatment and survival time. However, human papillomavirus (HPV) exposure, screening, and treatment vary among races and ethnicities in the United States. The purpose of this study is to examine disparities in characteristics of cervical cancer and survival of cases between White Hispanic (WH) and White non-Hispanic (WNH) women in the United States.


METHODS
We used a stratified random sampling method to select cervical cancer patient records from nine states; a simple random sampling method to extract the demographic and disease characteristics data within states from the Surveillance Epidemiology and End Results (SEER) database. We used statistical probability distribution methods for discrete and continuous data. The chi-square test and independent samples t-test were used to evaluate statistically significant differences. Furthermore, the Cox Proportional Regression and the Kaplan-Meier survival estimators were used to compare WH and WNH population survival times in the United States.


RESULTS
The samples of WNH and WH women included 4,000 cervical cancer cases from 1973-2009. There were statistically significant differences between ethnicities: marital status (p < 0.001); primary site of cancer (p < 0.001); lymph node involvement (p < 0.001); grading and differentiation (p < 0.0001); and tumor behavior (p < 0.001). The mean age of diagnosis for both groups showed no statistical differences. However, the mean survival time for WNH was 221.7 (standard deviation [SD] = 118.1) months and for WH was 190.3 (SD = 120.3), which differed significantly (p < 0.001).


CONCLUSIONS
Clear disparities exist in risk factors, cervical cancer characteristics, and survival time between WH and WNH women.
1 Department of Public Health, Texas Tech University Health Sciences Center , Lubbock, Texas.
Hafiz M R
HM
Khan
2 Department of Health Promotion and Disease Prevention, Florida International University , Miami, Florida.
Kemesha
K
Gabbidon
2 Department of Health Promotion and Disease Prevention, Florida International University , Miami, Florida.
Anshul
A
Saxena
3 Columbia University , Teacher's College, New York, New York.
Faheema
F
Abdool-Ghany
4 Department of Public Health, Texas Tech University Health Sciences Center , Abilene, Texas.
John M
JM
Dodge
1 Department of Public Health, Texas Tech University Health Sciences Center , Lubbock, Texas.
Taylor
T
Lenzmeier
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D054624:Health Status Disparities; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D053208:Kaplan-Meier Estimate; D016015:Logistic Models; D017533:Marital Status; D008875:Middle Aged; D016016:Proportional Hazards Models; D012111:Residence Characteristics; D018426:SEER Program / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D016019:Survival Analysis; D014481:United States / Q000453:epidemiology; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000208:ethnology*; D044465:White People / Q000706:statistics & numerical data*
SEER database; cervical cancer; statistical analysis