TY - JOUR
T1 - Racial/ethnic and socioeconomic disparities in mortality among women diagnosed with cervical cancer in New York City, 1995-2006
AU - McCarthy, Anne Marie
AU - Dumanovsky, Tamara
AU - Visvanathan, Kala
AU - Kahn, Amy R.
AU - Schymura, Maria J.
N1 - Funding Information:
Acknowledgments We thank Pei-Chi Chung, MD, Lorna Thorpe, Ph.D., Lynn Silver, MD, MPH, and the staff of the Bureau of Chronic Disease Prevention & Control and the Health Research Training Program at the NYC Department of Health and Mental Hygiene for their advice and cooperation on this project. Dr. Visvanathan is a recipient of an American Society of Clinical Oncology (ASCO) Career Development Award and a KO7 Preventive Oncology Academic Award (CA111948) from the National Cancer Institute.
PY - 2010/10
Y1 - 2010/10
N2 - Background: Though cervical cancer rates have declined due to Pap screening, racial and socioeconomic disparities in cervical cancer incidence and mortality persist. This study assesses the relative impact of race/ethnicity and neighborhood poverty on cervical cancer incidence and mortality in New York City (NYC). Methods: Invasive cervical cancer cases in NYC from 1995 to 2006 were identified along with demographic and socioeconomic measures. Odds ratios (OR) of late stage diagnosis were estimated using logistic regression. Hazard ratios (HR) of death were calculated using Cox proportional hazards regression. Results: From 1995 to 2006 cervical cancer incidence and mortality rates decreased in NYC, though black and Hispanic women had higher incidence and mortality rates than white women. Puerto Ricans (OR = 1.55, 95% CI = 1.20-2.01) and blacks (OR = 1.34, 95% CI = 1.15-1.57) were more likely to be diagnosed with late stage disease than whites. In multivariate analysis, blacks had similar mortality risk (HR 1.07, 95% CI = 0.95-1.20) to whites while Puerto Ricans had increased risk (HR = 1.31, 95% CI = 1.10-1.55), and non-Puerto Rican Hispanics (HR = 0.54, 95% CI = 0.45-0.63) and Asian/PIs (HR = 0.64, 95% CI = 0.52-0.78) had reduced risk. Women living in high poverty neighborhoods had higher mortality than women in higher income neighborhoods (HR = 1.32, 95% CI = 1.16-1.52). Conclusions: Black and Puerto Rican women in NYC are at greatest risk of dying from cervical cancer. Race/ethnicity is predictive of late stage diagnosis, while both race/ethnicity and neighborhood poverty are important predictors of cervical cancer mortality.
AB - Background: Though cervical cancer rates have declined due to Pap screening, racial and socioeconomic disparities in cervical cancer incidence and mortality persist. This study assesses the relative impact of race/ethnicity and neighborhood poverty on cervical cancer incidence and mortality in New York City (NYC). Methods: Invasive cervical cancer cases in NYC from 1995 to 2006 were identified along with demographic and socioeconomic measures. Odds ratios (OR) of late stage diagnosis were estimated using logistic regression. Hazard ratios (HR) of death were calculated using Cox proportional hazards regression. Results: From 1995 to 2006 cervical cancer incidence and mortality rates decreased in NYC, though black and Hispanic women had higher incidence and mortality rates than white women. Puerto Ricans (OR = 1.55, 95% CI = 1.20-2.01) and blacks (OR = 1.34, 95% CI = 1.15-1.57) were more likely to be diagnosed with late stage disease than whites. In multivariate analysis, blacks had similar mortality risk (HR 1.07, 95% CI = 0.95-1.20) to whites while Puerto Ricans had increased risk (HR = 1.31, 95% CI = 1.10-1.55), and non-Puerto Rican Hispanics (HR = 0.54, 95% CI = 0.45-0.63) and Asian/PIs (HR = 0.64, 95% CI = 0.52-0.78) had reduced risk. Women living in high poverty neighborhoods had higher mortality than women in higher income neighborhoods (HR = 1.32, 95% CI = 1.16-1.52). Conclusions: Black and Puerto Rican women in NYC are at greatest risk of dying from cervical cancer. Race/ethnicity is predictive of late stage diagnosis, while both race/ethnicity and neighborhood poverty are important predictors of cervical cancer mortality.
KW - Cervical cancer
KW - New York City
KW - Poverty
KW - Race/ethnicity
KW - Survival analysis
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U2 - 10.1007/s10552-010-9593-7
DO - 10.1007/s10552-010-9593-7
M3 - Article
C2 - 20521091
AN - SCOPUS:77956948144
SN - 0957-5243
VL - 21
SP - 1645
EP - 1655
JO - Cancer Causes and Control
JF - Cancer Causes and Control
IS - 10
ER -