| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
ORIGINAL RESEARCH |
From the Robert Wood Johnson Clinical Scholars Program, the Department of Medicine, Yale University School of Medicine, New Haven, Connecticut; and the Clinical Epidemiology Unit, West Haven Veterans Affairs Medical Center, West Haven, Connecticut.
Address reprint requests to: Elizabeth Howell, MD, MPP Robert Wood Johnson Clinical Scholars Yale University School of Medicine IE-61 SHM, 333 Cedar Street New Haven, CT 06520-8025 E-mail: elizabeth.howell{at}yale.edu
Objective: To determine whether stage of disease and treatment patterns account for mortality differences between black and white women with cervical cancer.
Methods: Using data obtained from the Surveillance, Epidemiology, and End Results (SEER) Program for 1988–1994, we determined the associations between race and stage, and race and treatment. Racial differences in survival for up to 7 years of follow-up were adjusted for age, marital status, SEER location, International Federation of Gynecology and Obstetrics (FIGO) stage of disease, lymph node status, grade, histology, and treatment.
Results: Cumulative mortality was 36% (366 deaths in 1029 women) for black women and 24% (1215 deaths in 5021 women) for white women; unadjusted hazard ratio was 1.60 (95% confidence interval [CI] 1.43, 1.80). Black women were more likely to present with advanced disease than white women (43.8% compared with 34.8%). In a model adjusting for demographics and FIGO stage, the hazard ratio for black women compared with white women decreased to 1.35 (95% CI 1.19, 1.54). Treatment varied by race, with black women receiving surgery less often (33.5% compared with 48.2%, respectively) and radiation therapy more often (35.3% and 25.2%, respectively) than white women. In a comprehensive model including demographic factors, FIGO stage, other tumor characteristics, and treatment, the adjusted hazard ratio for mortality remained high for black women at 1.30 (95% CI 1.14, 1.48).
Conclusion: Race remains an independent predictor of cervical cancer survival after accounting for age, stage of disease, treatment patterns, and other factors. Future studies should assess racial differences in clinical severity of disease, comorbidity, and socioeconomic status.
This article has been cited by other articles:
|
|
 |
|
  E. W. Steyerberg, B. Neville, J. C. Weeks, and C. C. Earle Referral Patterns, Treatment Choices, and Outcomes in Locoregional Esophageal Cancer: A Population-Based Analysis of Elderly Patients J. Clin. Oncol., June 10, 2007; 25(17): 2389 - 2396. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. B. Barton Exploring and crossing the disparity divide in cancer mortality. Ann Intern Med, April 18, 2006; 144(8): 614 - 616. [Full Text] [PDF]
|
|
|
|
 |
|
 C. J. Bradley, C. W. Given, and C. Roberts Health Care Disparities and Cervical Cancer Am J Public Health, December 1, 2004; 94(12): 2098 - 2103. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. O. Smith, C. R. Qualls, B. A. Prairie, L. A. Padilla, W. F. Rayburn, and C. R. Key Trends in Gestational Choriocarcinoma: A 27-Year Perspective Obstet. Gynecol., November 1, 2003; 102(5): 978 - 987. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. I. O. Garner Cervical Cancer: Disparities in Screening, Treatment, and Survival Cancer Epidemiol. Biomarkers Prev., March 1, 2003; 12(3): 242S - 247. [Full Text]
|
|
|
|
 |
|
 P. B. Bach, D. Schrag, O. W. Brawley, A. Galaznik, S. Yakren, and C. B. Begg Survival of Blacks and Whites After a Cancer Diagnosis JAMA, April 24, 2002; 287(16): 2106 - 2113. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 V. L. Shavers and M. L. Brown Racial and Ethnic Disparities in the Receipt of Cancer Treatment J Natl Cancer Inst, March 6, 2002; 94(5): 334 - 357. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Racial Differences Exist in Cervical Cancer Mortality Rates Journal Watch (General), October 29, 1999; 1999(1029): 5 - 5. [Full Text]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
