Cervical cancer sociodemographic and diagnostic disparities in Florida: a population-based study (1981–2013) by stage at presentation. Issue 7 (2nd October 2020)

• Record Type: Journal Article
• Authors: Gauri, Aliyah; Messiah, Sarah E.; Bouzoubaa, Layla A.; Moore, Kevin J.; Koru-Sengul, Tulay
• Is Part Of: Ethnicity & health. Volume 25:Issue 7(2020)
• Page Start: 995
• Page End: 1003
• Publication Date: 2020-10-02
• Subjects: Cervical cancer -- cancer stage -- disparities -- Florida -- race -- ethnicity; Ethnic groups -- Health and hygiene -- Periodicals; Ethnic groups -- Medical care -- Periodicals; Medical care -- Cross-cultural studies -- Periodicals; Ethnic Groups -- periodicals; Delivery of Health Care -- periodicals; Social Sciences -- periodicals; 362.1089
• DOI: 10.1080/13557858.2018.1471669
• Languages: English
• ISSNs: 1355-7858

Abstract

ABSTRACT: Objective: Florida has one of the highest cervical cancer mortality rates and socioeconomically diverse populations in the United States. We used statewide population-based cancer registry data to assess disparities in cervical cancer stage at diagnosis. Design: Primary invasive adult female cervical cancer patients in the Florida Cancer Data Registry (1981–2013) were linked with 2000 United States Census data. Early (localized) and advanced (regional and distant) stage at diagnosis was assessed by age, race, ethnicity, neighborhood socioeconomic-, marital-, and smoking- status. Univariate and multivariable logistic regression models were fit to identify factors associated with the risk of advanced cervical cancer stage at diagnosis. Adjusted odds ratios (aOR) and corresponding 95% confidence intervals (95%CI) were calculated. Results: Of 18, 279 women (meanage 51.3 years old), most were non-Hispanic (83.5%), white (79.1%), middle-low neighborhood socioeconomic status (NSES) (34.7%), married (46.0%), and never smoked (56.0%). Higher odds of advanced stage was observed for blacks (aOR: 1.42, 95%CI: 1.30–1.55, p < 0.001) compared to whites, Hispanics (1.15, 1.06–1.25, p = 0.001) compared to non-Hispanics, and middle-low (1.13, 1.02–1.25, p = 0.02) and low NSES (1.42, 1.28–1.57, p < 0.001) compared to high NSES. Previously (1.30, 1.21–1.39, p < 0.001) and never married (1.37, 1.27–1.48, p < 0.001) had higher odds of presenting with advanced stage versus married women. Never smokers had decreased odds of presenting with advanced stage compared to women with history of (1.41, 1.32–1.52, p < 0.001) or current (1.29, 1.18-1.42, p < 0.001)smoking status. Conclusions: There are cancer disparities in women of black race, Hispanic ethnicity and of middle-low and lowest NSES in Florida. Evidence-based interventions targeting these vulnerable groups are needed. Abbreviations: HPV: Human Papilloma Virus; CDC: Center for Disease Control and Prevention; SES: socioeconomic status; FCDS: Florida Cancer Data System; NSES: Neighborhood Socioeconomic Status; NPCR: National Program of Cancer Registries; IRB: Institutional Review Board; ACS: American Community Survey; SEER: Surveillance, Epidemiology and End Results; OR: Odds Ratio; CI: Confidence Interval