Health disparities in cervical cancer: Prevalence of high‐risk HPV and cytologic diagnoses according to race. Issue 11 (29th June 2020)

• Record Type: Journal Article
• Authors: Miller, Daniel; Morris, C. Paul; Maleki, Zahra; White, Marissa; Rodriguez, Erika F.
• Is Part Of: Cancer cytopathology. Volume 128:Issue 11(2020)
• Page Start: 860
• Page End: 869
• Publication Date: 2020-06-29
• Subjects: early detection of cancer -- health inequalities -- human papillomavirus infections -- Papanicolaou test -- uterine cervical neoplasms; Cancer -- Cytopathology -- Periodicals; Pathology, Cellular -- Periodicals; Cytology -- Technique -- Periodicals; 611.01815
• DOI: 10.1002/cncy.22316
• Languages: English
• ISSNs: 1934-662X

Abstract

Abstract : Background: In the United States, the rate of cervical cancer is disproportionally higher in Hispanic and Black women compared with White women. In the current study, the authors compared human papillomavirus (HPV) testing and cytology results among Black and White women over a 24‐month period. They then assessed the rates in young women in 2011 compared with 2017 according to race. Methods: The authors searched the gynecologic cytology case files for Black and White women treated at Johns Hopkins Hospital across all ages for a period of 24 months (2017‐2019) and compared HPV results and cytologic interpretations. They then compared results among Black and White cohorts of young women (aged 21‐29 years) in 2011 versus 2017. Results: A total of 26, 302 specimens from January 2017 to January 2019, including 11, 676 Black women and 14, 626 White women, were reviewed. The most common HPV genotype(s) detected were non–HPV‐16 and/or HPV‐18 (non‐16/18) high‐risk HPV (hrHPV) (84% of positive results). Non‐16/18 hrHPV was more common in Black women (1309 women; 15%) compared with White women (1075 women; 9%). Non‐16/18 hrHPV was more commonly observed in association with atypical squamous cells, cannot rule out high‐grade squamous intraepithelial lesion and/or high‐grade squamous intraepithelial lesion (ASC‐H/HSIL) in HPV‐positive Black women compared with White women ( P = .007). Black women were found to have higher rates of HPV‐positive Papanicolaou results and high‐grade lesions, including carcinoma ( P < .01). In the 2011 cohort, young Black women were found to have a higher rate of ASC‐H/HSIL ( P = .003) compared with White women. However, the difference was not noted in the 2017 cohort. There was a decrease in ASC‐H/HSIL in 2017 compared with 2011, with a lower incidence of ASC‐H/HSIL noted among Black women in 2017. Conclusions: Black women appear to have a higher incidence of higher grade lesions, but the difference between Black and White cohorts was not found to be significant in young women in more recent years. Abstract : Over 24 months of Papanicolaou (Pap) testing, Black women appear to have a higher rate of high‐risk human papillomavirus (hrHPV), hrHPV‐positive and Pap‐negative, non–HPV‐16 and/or HPV‐18 hrHPV, high‐grade cytology, and carcinoma (squamous cell carcinoma and adenocarcinoma in situ) compared with White women. Among young Black women (those aged 21 to 29 years), a lower incidence of high‐grade squamous intraepithelial lesion and atypical squamous cells, cannot rule out high‐grade squamous intraepithelial lesion is noted in 2017 compared with 2011, whereas only slightly lower odds are observed for White patients over the same time frame.