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.

The Impact of Race and Geographical Location on the Treatment Options of Cervical Cancer in Black and White Women Living in the State of Alabama.

This study assesses the association between age, race, geographical-location, stage, and treatments of Cervical Cancer (CerCancer) in Black and White women, living in Alabama. Data from 2004-2013 was provided by the Alabama Cancer Registry. To perform Chi-square and logistic regression tests, SAS-software was used for analysis. In urban counties, Blacks 40-49 years old diagnosed with localized stage of CerCancer were the most likely to receive surgery (74.14%; P < .0001), followed by Whites 17-39 years old diagnosed with regional stage, were the most likely to receive radiation and surgery-radiation sequence (66.32 and 66.67%; P < .0001) respectively. Also, Whites 50 years and older diagnosed with regional stage were the most likely to receive chemotherapy (65.87%; P < .0001). In rural counties, Blacks 40-49 years old diagnosed with regional stage were the most likely to receive radiation (70.37%) and chemotherapy (83.33%) with P = .005 and .003 respectively, followed by Whites 17-39 years old diagnosed with localized stage were the most likely to receive surgery (76.81%; P < .0001). Adjusting for age, stage and county, Blacks had 1.12 (95% CI = .88-1.42) times the odds of receiving more radiation treatment. Blacks had .76 times adjusted odds (95% CI .59-.99) of receiving less surgery compared to Whites. Treatment disparities exist between Blacks and Whites in Alabama.

Disparities in Cervical Cancer Treatment Options between African American (Black) and White Women in Alabama.

There are disparities in cervical cancer treatment options between African American (Black) and White women in Alabama. The objective of this study was to identify and assess factors contributing to the prevailing inequalities in cervical cancer treatment options between Blacks and Whites, who are living in urban, rural Black Belt (BB), and other rural counties of Alabama. The data of our study population, which was comprised of 2,124 cases of cervical cancer in women 17 years and older, were extracted from the 2004 to 2013 dataset of the Alabama Department of Public Health (ADPH) Cancer Registry. For the analysis of frequency distributions, chi-square, and logistic regression tests SAS software was used. Racial disparities in cervical cancer treatment options for Blacks living within the same counties as Whites still exist. The study analysis showed that younger Blacks living in urban counties with advanced stages of cervical cancer were more likely to receive radiation treatment options but were less likely to undergo surgical treatment options (p-value <.0001). Younger Blacks living in the rural BB and other rural counties were mainly treated with radiation options for the early stages of cervical cancer (p-value 0.001), while older ones received surgery options (p-value <.0001), and combined therapy of surgery and radiation options (p-value 0.05). When adjusted for age, stage of cancer, and county of residence, Blacks had 2.76 (95% CI 0.90-8.86) times the odds ratio of receiving immunotherapy options compared to Whites. Blacks had 0.74 (95% CI 0.58-0.95) times adjusted odds ratio of undergoing less surgery option compared to Whites. Our study findings suggest that cervical cancer treatment options and control interventions targeted towards disadvantaged women, particularly Blacks living in the rural BB and other rural counties have the potential to reduce and/or eradicate this preventable disease.