TY - JOUR
T1 - Recent trends in racial and regional disparities in cervical cancer incidence and mortality in United States
AU - Yoo, Wonsuk
AU - Kim, Sangmi
AU - Huh, Warner K.
AU - Dilley, Sarah
AU - Coughlin, Steven S.
AU - Partridge, Edward E.
AU - Chung, Yunmi
AU - Dicks, Vivian Gail
AU - Lee, Jae Kwan
AU - Bae, Sejong
N1 - Funding Information:
This article was partially supported by the National Cancer Institute (P30 CA013148, P50CA098252, 2U54 CA118948), National Institute on Minority Health and Health Disparities (U54MD008149, U54MD008176), and Atlanta Clinical & Translational Science Institute (UL1TR000454). We would like to express our gratitude to anonymous peer reviewers for carefully revising our manuscript and for his/her comments.
Publisher Copyright:
© 2017 Yoo et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PY - 2017/2
Y1 - 2017/2
N2 - Background Although black women experienced greater cervical cancer incidence and mortality rate reduction in recent years, they continue to have higher incidence rates than whites. Great variations also exist among geographic regions of the US, with the South having both the highest incidence and mortality rates compared to other regions. The present study explores the question of whether living in the South is associated with greater racial disparity in cervical cancer incidence and mortality by examining race- and region-specific rates and the trend between 2000 and 2012. Methods The Surveillance, Epidemiology, and End Results (SEER) 18 Program data was used. Cervical cancer incidence and mortality rates, annual percent changes, and disparity ratios were calculated using SEER∗Stat software and Joinpoint regression for four groups: US14- Non-Hispanic White (NHW), US14-Non-Hispanic Black (NHB), South-NHW, and South- NHB, where South included 4 registries from Georgia and Louisiana and US14 were 14 US registries except the four South registries. Results The average age-adjusted cervical cancer incidence rate was the highest among South- NHBs (11.1) and mortality rate was the highest among US14-NHBs (5.4). In 2012, the degree of racial disparities between South-NHBs and South-NHWs was greater in terms of mortality rates (NHB:NHW = 1.80:1.35) than incidence rates (NHB:NHW = 1.45:1.15). While mortality disparity ratios decreased from 2000-2012 for US14-NHB (APC: -1.9(-2.3,- 1.4), mortality disparity ratios for South-NHWs (although lower than NHBs) increased compared to US14-NHW. Incidence rates for NHBs continued to increase with increasing age, whereas rates for NHWs decreased after age 40. Mortality rates for NHBs dramatically increased at age 65 compared to a relatively stable trend for NHWs. The increasing racial disparity with increasing age in terms of cervical cancer incidence rates became more pronounced when corrected for hysterectomy prevalence. Conclusions Black race and South region were associated with higher cervical cancer incidence and mortality. Cervical cancer rates uncorrected for hysterectomy may underestimate regional and racial disparities. Increasing incidence rates for older NHBs compared to NHWs warrant further research to determine whether screening should continue for NHBs over age 65.
AB - Background Although black women experienced greater cervical cancer incidence and mortality rate reduction in recent years, they continue to have higher incidence rates than whites. Great variations also exist among geographic regions of the US, with the South having both the highest incidence and mortality rates compared to other regions. The present study explores the question of whether living in the South is associated with greater racial disparity in cervical cancer incidence and mortality by examining race- and region-specific rates and the trend between 2000 and 2012. Methods The Surveillance, Epidemiology, and End Results (SEER) 18 Program data was used. Cervical cancer incidence and mortality rates, annual percent changes, and disparity ratios were calculated using SEER∗Stat software and Joinpoint regression for four groups: US14- Non-Hispanic White (NHW), US14-Non-Hispanic Black (NHB), South-NHW, and South- NHB, where South included 4 registries from Georgia and Louisiana and US14 were 14 US registries except the four South registries. Results The average age-adjusted cervical cancer incidence rate was the highest among South- NHBs (11.1) and mortality rate was the highest among US14-NHBs (5.4). In 2012, the degree of racial disparities between South-NHBs and South-NHWs was greater in terms of mortality rates (NHB:NHW = 1.80:1.35) than incidence rates (NHB:NHW = 1.45:1.15). While mortality disparity ratios decreased from 2000-2012 for US14-NHB (APC: -1.9(-2.3,- 1.4), mortality disparity ratios for South-NHWs (although lower than NHBs) increased compared to US14-NHW. Incidence rates for NHBs continued to increase with increasing age, whereas rates for NHWs decreased after age 40. Mortality rates for NHBs dramatically increased at age 65 compared to a relatively stable trend for NHWs. The increasing racial disparity with increasing age in terms of cervical cancer incidence rates became more pronounced when corrected for hysterectomy prevalence. Conclusions Black race and South region were associated with higher cervical cancer incidence and mortality. Cervical cancer rates uncorrected for hysterectomy may underestimate regional and racial disparities. Increasing incidence rates for older NHBs compared to NHWs warrant further research to determine whether screening should continue for NHBs over age 65.
UR - http://www.scopus.com/inward/record.url?scp=85013968513&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85013968513&partnerID=8YFLogxK
U2 - 10.1371/journal.pone.0172548
DO - 10.1371/journal.pone.0172548
M3 - Article
C2 - 28234949
AN - SCOPUS:85013968513
SN - 1932-6203
VL - 12
JO - PLoS One
JF - PLoS One
IS - 2
M1 - e0172548
ER -
