A Comparative Study of Health Disparities in Cervical Cancer Mortality Rates Through Time Between Black and Caucasian Women in Alabama and the US.

Background: The main purpose of this study was to assess changes in cervical cancer mortality rates through time between Black and Caucasian women residing in Alabama and the US. Methods: Alabama cervical cancer mortality rates (MR), percentage differences, percentage changes and annual percentage changes for trends were compared with the US baseline and target rates. The US Baseline data and target objectives of utilization of cervical cancer screening and MR were obtained from Healthy People 2020. The cervical cancer behavioral risk factors and utilization of screening tests data were obtained from CDC's Behavioral Risk Factor Surveillance System (BRFSS). The cervical cancer MR data were obtained from the Surveillance, Epidemiology, and End Results (SEER). The analysis was done using SEER*Stat and Linear Trendlines analysis. Results: Although Blacks in Alabama had higher cervical cancer MR through times, a decreasing trend was noted for both races. However, in Alabama, there is no significant change in Blacks aged 65 years and older in cervical cancer MR, despite a high screening rate compared to Whites. In contrast, between 2002 and 2012, Whites in Alabama and the US made a significant progress toward the Healthy People 2020 goal. Conclusions: In Alabama, there exists cervical cancer MR disparity in Blacks despite the higher rates of screening for cervical cancer as would otherwise be expected. The state has not yet achieved the Healthy People 2020 goal. Public health officials should monitor progress toward reduction and/or elimination of these disparities by focusing in a follow up of screening.

Racial differences in 5-year relative survival rates of cervical cancer by stage at diagnosis, between African American (black) and white women, living in the state of Alabama, USA.

BACKGROUND: Our objective was to assess racial differences in the 5-year relative survival rates (RSRs) of Cervical Cancer (CerCancer) by stage at diagnosis, between Black and White women, living in Alabama, USA. METHODS: Data for 3484 Blacks and 21,059 Whites diagnosed with CerCancer were extracted from the 2004 to 2013 Surveillance, Epidemiology, and End Results (SEER) database. We incorporated age groups, CerCancer stages, county, and year of diagnosis to compare the RSR between Blacks and Whites, using SEER*Stat software. RESULTS: In urban, Black Belt (BB) and other rural counties, Whites diagnosed with localized stage of CerCancer always had better chances of survival because their RSRs were always more than 77%, compared to Blacks. Only exception was in Blacks living in other rural counties, who had a significantly higher RSR of 83.8% (95% Cl, 74.2-90.1). Which was the same as in Whites (83.8% (95% CI 74.5-89.9) living in BBC. Although, in other rural counties, Whites had a slightly lower RSR of 83.7% (95% CI 79.9-86.8%), their RSR was better compared to Blacks and Whites living in BB and other rural counties who had slightly higher RSRs of 83.8%. This was due to statistical precision, which depended on their larger sample size and a lower variability therefore, more reliability resulting in a tighter confidence interval with a smaller margin of error. In all the three county groups, Whites 15-44 years old diagnosed with localized stage of CerCancer had a higher RSR of 93.6% (95% CI 91.4-95.2%) for those living in urban and BB counties, and 94.6% (95% CI 93.6-95.4) for those living in other rural counties. The only exception was in Blacks 65-74 years old living in other rural counties who had the highest RSR of 96.9% (95% Cl, 82.9-99.5). However, Whites were considered to have a better RSR. This was also due to the statistical precision as mentioned above. CONCLUSION: There were significant racial differences in the RSRs of CerCancer. Overall, Black women experienced the worst RSRs compared to their White counterparts.

Community food environment measures in the Alabama Black Belt: Implications for cancer risk reduction.

In-store measures were utilized to evaluate the availability of healthy food choices and nutrition/health promotion messages for cancer risk reduction in the selected Alabama Black Belt counties/cities. Sixty one retail food outlets (RFOs) were audited in 12 Alabama Black Belt cities. Store types included convenience stores (49.2%), restaurants (19.7%), fast food restaurants (16.4%), small supermarkets (8.2%), and large supermarket and farmers' markets (3.3 %), respectively. Although there were low numbers of farmers' markets/street stands and large supermarkets, these had significantly (p < 0.0001) higher health scores than the other store types. A few health promotion messages were highly visible or obscurely positioned in some RFOs. The Alabama Black Belt food environment had limited opportunities for healthy food choices.