Racial, Geographic and Socioeconomic Risk Factors for Development of Advanced Stage Cervical Cancer [15J]. Issue 1 (May 2017)

• Record Type: Journal Article
• Authors: Dilley, Sarah; Powell, T. Clark; Bae, Sejong; Straughn, J. Michael; Leath, Charles A.; Kim, Kenneth H.
• Is Part Of: Obstetrics and gynecology. Volume 129:Issue 1(2017)
• Publication Date: 2017-05
• Subjects: Obstetrics -- Periodicals; Gynecology -- Periodicals; 618
• DOI: 10.1097/01.AOG.0000514990.39187.95
• Languages: English
• ISSNs: 0029-7844

Abstract

Abstract : INTRODUCTION: We investigated sociodemographic risk factors for developing advanced stage (AS) cervical cancer, as well as the impact of distance to a women's health provider on stage at diagnosis. METHODS: Our institution tumor registry was queried to identify women treated for cervical cancer from 2005-2015. AS cancer was considered Stage II-IV. Utilizing American College of Obstetricians and Gynecologists data, we calculated minimum distance from patient to the nearest women's health provider. Associations between stage and multiple factors were calculated using logistic regression. RESULTS: 934 patients were included, 273 black and 661 white. Mean age at diagnosis: 49.8 (SD 14.7). 493 patients had AS cervical cancer. Average distance to a women's health provider (ACOG Fellow): 7.4 miles. 346 women had private insurance, 431 had public insurance, 128 were uninsured. Black race (OR 1.43) and age > 50 (OR 1.75) were associated with increased risk of AS cancer, however a shorter minimum distance to the nearest women's health provider (OR 0.995) was not. When stratified by race, insurance status did not have a significant impact on stage at diagnosis for black women. Among white women, those who were uninsured (OR 1.69) or with public insurance (OR 1.93) were more likely to be diagnosed with AS cancer than those with private insurance. CONCLUSION: In our analysis, black race remains a strong predictor of diagnosis of AS cervical cancer. These results warrant further investigation into the socioeconomic, cultural and biological barriers to early diagnosis for black women, and highlight the importance of focusing on high-risk populations in efforts to improve cervical cancer screening and prevention.