Ethnic differences in patterns of care of Stage 1A1 and Stage 1A2 cervical cancer: A SEER database study

Marcela G. Del Carmen, F. J. Montz, Robert E. Bristow, Alessandro Bovicelli, T. Cornelison, Edward Trimble

Research output: Contribution to journalArticle

Abstract

Objective. The aim of this study was to evaluate patterns of care for women with Stage 1A1 and 1A2 cervical cancer utilizing the SEER database. Methods. Review of SEER data from 11 registries from 1990 to 1995 was performed. Data from 2358 women were reviewed and stratified by substage, ethnicity, type of therapy, and age. Results. Three remarkable differences among subgroups were identified. (1) Among women ≥35 years of age, whites were more likely to have Stage 1A1 cancer than blacks or Hispanics; OR (95% CI) = 1.56 (1.05, 2.31) and 1.41 (1.04, 1.91), respectively. (2) Patients ≥35 years of age were more likely to undergo hysterectomy than younger patients both for 1A1 and 1A2 stages; OR (95% CI) = 2.31 (1.68, 3.19) and 2.78 (2.21, 3.50), respectively, with Mantel-Haenszel test of independence χ2 = 102.9943, P value <0.001. (3) Black and Hispanic women ≥35 years of age with 1A2 disease were less likely to have a hysterectomy than whites. Only 15% of Hispanic patients and 9% of blacks over the age of 35 and with Stage 1A2 were treated via hysterectomy, compared to 76% of white women. Differences in hysterectomies for 1 patients approached but did not reach statistical significance: blacks 36% versus Hispanic/whites 59%, P value = 0.07. Conclusions. Older white women were more likely to have cervical carcinoma diagnosed at an earlier stage (1A1) than age-matched blacks or Hispanics. Older patients, across all ethnic groups analyzed, were also more likely to be treated for both Stage 1A1 and 1A2 disease via hysterectomy than younger patients. Ethnic differences in the management of women with Stage 1A2 cervical cancer do exist: older minority women are less likely to have a hysterectomy and more likely to be treated via fertility- sparing, less definitive procedures than whites.

Original languageEnglish (US)
Pages (from-to)113-117
Number of pages5
JournalGynecologic Oncology
Volume75
Issue number1
DOIs
StatePublished - Oct 1999

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Uterine Cervical Neoplasms
Hysterectomy
Databases
Hispanic Americans
Ethnic Groups
Fertility
Registries
Carcinoma
Neoplasms

Keywords

  • Cervical cancer
  • Microinvasive
  • SEER data

ASJC Scopus subject areas

  • Obstetrics and Gynecology
  • Oncology

Cite this

Ethnic differences in patterns of care of Stage 1A1 and Stage 1A2 cervical cancer : A SEER database study. / Del Carmen, Marcela G.; Montz, F. J.; Bristow, Robert E.; Bovicelli, Alessandro; Cornelison, T.; Trimble, Edward.

In: Gynecologic Oncology, Vol. 75, No. 1, 10.1999, p. 113-117.

Research output: Contribution to journalArticle

Del Carmen, Marcela G. ; Montz, F. J. ; Bristow, Robert E. ; Bovicelli, Alessandro ; Cornelison, T. ; Trimble, Edward. / Ethnic differences in patterns of care of Stage 1A1 and Stage 1A2 cervical cancer : A SEER database study. In: Gynecologic Oncology. 1999 ; Vol. 75, No. 1. pp. 113-117.
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abstract = "Objective. The aim of this study was to evaluate patterns of care for women with Stage 1A1 and 1A2 cervical cancer utilizing the SEER database. Methods. Review of SEER data from 11 registries from 1990 to 1995 was performed. Data from 2358 women were reviewed and stratified by substage, ethnicity, type of therapy, and age. Results. Three remarkable differences among subgroups were identified. (1) Among women ≥35 years of age, whites were more likely to have Stage 1A1 cancer than blacks or Hispanics; OR (95{\%} CI) = 1.56 (1.05, 2.31) and 1.41 (1.04, 1.91), respectively. (2) Patients ≥35 years of age were more likely to undergo hysterectomy than younger patients both for 1A1 and 1A2 stages; OR (95{\%} CI) = 2.31 (1.68, 3.19) and 2.78 (2.21, 3.50), respectively, with Mantel-Haenszel test of independence χ2 = 102.9943, P value <0.001. (3) Black and Hispanic women ≥35 years of age with 1A2 disease were less likely to have a hysterectomy than whites. Only 15{\%} of Hispanic patients and 9{\%} of blacks over the age of 35 and with Stage 1A2 were treated via hysterectomy, compared to 76{\%} of white women. Differences in hysterectomies for 1 patients approached but did not reach statistical significance: blacks 36{\%} versus Hispanic/whites 59{\%}, P value = 0.07. Conclusions. Older white women were more likely to have cervical carcinoma diagnosed at an earlier stage (1A1) than age-matched blacks or Hispanics. Older patients, across all ethnic groups analyzed, were also more likely to be treated for both Stage 1A1 and 1A2 disease via hysterectomy than younger patients. Ethnic differences in the management of women with Stage 1A2 cervical cancer do exist: older minority women are less likely to have a hysterectomy and more likely to be treated via fertility- sparing, less definitive procedures than whites.",
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T1 - Ethnic differences in patterns of care of Stage 1A1 and Stage 1A2 cervical cancer

T2 - A SEER database study

AU - Del Carmen, Marcela G.

AU - Montz, F. J.

AU - Bristow, Robert E.

AU - Bovicelli, Alessandro

AU - Cornelison, T.

AU - Trimble, Edward

PY - 1999/10

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N2 - Objective. The aim of this study was to evaluate patterns of care for women with Stage 1A1 and 1A2 cervical cancer utilizing the SEER database. Methods. Review of SEER data from 11 registries from 1990 to 1995 was performed. Data from 2358 women were reviewed and stratified by substage, ethnicity, type of therapy, and age. Results. Three remarkable differences among subgroups were identified. (1) Among women ≥35 years of age, whites were more likely to have Stage 1A1 cancer than blacks or Hispanics; OR (95% CI) = 1.56 (1.05, 2.31) and 1.41 (1.04, 1.91), respectively. (2) Patients ≥35 years of age were more likely to undergo hysterectomy than younger patients both for 1A1 and 1A2 stages; OR (95% CI) = 2.31 (1.68, 3.19) and 2.78 (2.21, 3.50), respectively, with Mantel-Haenszel test of independence χ2 = 102.9943, P value <0.001. (3) Black and Hispanic women ≥35 years of age with 1A2 disease were less likely to have a hysterectomy than whites. Only 15% of Hispanic patients and 9% of blacks over the age of 35 and with Stage 1A2 were treated via hysterectomy, compared to 76% of white women. Differences in hysterectomies for 1 patients approached but did not reach statistical significance: blacks 36% versus Hispanic/whites 59%, P value = 0.07. Conclusions. Older white women were more likely to have cervical carcinoma diagnosed at an earlier stage (1A1) than age-matched blacks or Hispanics. Older patients, across all ethnic groups analyzed, were also more likely to be treated for both Stage 1A1 and 1A2 disease via hysterectomy than younger patients. Ethnic differences in the management of women with Stage 1A2 cervical cancer do exist: older minority women are less likely to have a hysterectomy and more likely to be treated via fertility- sparing, less definitive procedures than whites.

AB - Objective. The aim of this study was to evaluate patterns of care for women with Stage 1A1 and 1A2 cervical cancer utilizing the SEER database. Methods. Review of SEER data from 11 registries from 1990 to 1995 was performed. Data from 2358 women were reviewed and stratified by substage, ethnicity, type of therapy, and age. Results. Three remarkable differences among subgroups were identified. (1) Among women ≥35 years of age, whites were more likely to have Stage 1A1 cancer than blacks or Hispanics; OR (95% CI) = 1.56 (1.05, 2.31) and 1.41 (1.04, 1.91), respectively. (2) Patients ≥35 years of age were more likely to undergo hysterectomy than younger patients both for 1A1 and 1A2 stages; OR (95% CI) = 2.31 (1.68, 3.19) and 2.78 (2.21, 3.50), respectively, with Mantel-Haenszel test of independence χ2 = 102.9943, P value <0.001. (3) Black and Hispanic women ≥35 years of age with 1A2 disease were less likely to have a hysterectomy than whites. Only 15% of Hispanic patients and 9% of blacks over the age of 35 and with Stage 1A2 were treated via hysterectomy, compared to 76% of white women. Differences in hysterectomies for 1 patients approached but did not reach statistical significance: blacks 36% versus Hispanic/whites 59%, P value = 0.07. Conclusions. Older white women were more likely to have cervical carcinoma diagnosed at an earlier stage (1A1) than age-matched blacks or Hispanics. Older patients, across all ethnic groups analyzed, were also more likely to be treated for both Stage 1A1 and 1A2 disease via hysterectomy than younger patients. Ethnic differences in the management of women with Stage 1A2 cervical cancer do exist: older minority women are less likely to have a hysterectomy and more likely to be treated via fertility- sparing, less definitive procedures than whites.

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