Cervical cancer sociodemographic and diagnostic disparities in Florida

a population-based study (1981–2013) by stage at presentation

Aliyah Gauri, Sarah Messiah, Layla A. Bouzoubaa, Kevin J. Moore, Tulay Sengul

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Objective: Florida has one of the highest cervical cancer mortality rates and socioeconomically diverse populations in the United States. We used statewide population-based cancer registry data to assess disparities in cervical cancer stage at diagnosis. Design: Primary invasive adult female cervical cancer patients in the Florida Cancer Data Registry (1981–2013) were linked with 2000 United States Census data. Early (localized) and advanced (regional and distant) stage at diagnosis was assessed by age, race, ethnicity, neighborhood socioeconomic-, marital-, and smoking- status. Univariate and multivariable logistic regression models were fit to identify factors associated with the risk of advanced cervical cancer stage at diagnosis. Adjusted odds ratios (aOR) and corresponding 95% confidence intervals (95%CI) were calculated. Results: Of 18,279 women (meanage 51.3 years old), most were non-Hispanic (83.5%), white (79.1%), middle-low neighborhood socioeconomic status (NSES) (34.7%), married (46.0%), and never smoked (56.0%). Higher odds of advanced stage was observed for blacks (aOR: 1.42, 95%CI: 1.30–1.55, p < 0.001) compared to whites, Hispanics (1.15, 1.06–1.25, p = 0.001) compared to non-Hispanics, and middle-low (1.13, 1.02–1.25, p = 0.02) and low NSES (1.42, 1.28–1.57, p < 0.001) compared to high NSES. Previously (1.30, 1.21–1.39, p < 0.001) and never married (1.37, 1.27–1.48, p < 0.001) had higher odds of presenting with advanced stage versus married women. Never smokers had decreased odds of presenting with advanced stage compared to women with history of (1.41, 1.32–1.52, p < 0.001) or current (1.29, 1.18-1.42, p < 0.001)smoking status. Conclusions: There are cancer disparities in women of black race, Hispanic ethnicity and of middle-low and lowest NSES in Florida. Evidence-based interventions targeting these vulnerable groups are needed. Abbreviations: HPV: Human Papilloma Virus; CDC: Center for Disease Control and Prevention; SES: socioeconomic status; FCDS: Florida Cancer Data System; NSES: Neighborhood Socioeconomic Status; NPCR: National Program of Cancer Registries; IRB: Institutional Review Board; ACS: American Community Survey; SEER: Surveillance, Epidemiology and End Results; OR: Odds Ratio; CI: Confidence Interval

Original languageEnglish (US)
Pages (from-to)1-9
Number of pages9
JournalEthnicity and Health
DOIs
StateAccepted/In press - May 8 2018

Fingerprint

Social Class
Uterine Cervical Neoplasms
diagnostic
cancer
social status
Population
Registries
Research Ethics Committees
Odds Ratio
Confidence Intervals
Neoplasms
Centers for Disease Control and Prevention (U.S.)
Hispanic Americans
Papillomaviridae
confidence
Logistic Models
Smoking
smoking
ethnicity
Marital Status

Keywords

  • cancer stage
  • Cervical cancer
  • disparities
  • ethnicity
  • Florida
  • race

ASJC Scopus subject areas

  • Cultural Studies
  • Arts and Humanities (miscellaneous)
  • Public Health, Environmental and Occupational Health

Cite this

Cervical cancer sociodemographic and diagnostic disparities in Florida : a population-based study (1981–2013) by stage at presentation. / Gauri, Aliyah; Messiah, Sarah; Bouzoubaa, Layla A.; Moore, Kevin J.; Sengul, Tulay.

In: Ethnicity and Health, 08.05.2018, p. 1-9.

Research output: Contribution to journalArticle

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title = "Cervical cancer sociodemographic and diagnostic disparities in Florida: a population-based study (1981–2013) by stage at presentation",
abstract = "Objective: Florida has one of the highest cervical cancer mortality rates and socioeconomically diverse populations in the United States. We used statewide population-based cancer registry data to assess disparities in cervical cancer stage at diagnosis. Design: Primary invasive adult female cervical cancer patients in the Florida Cancer Data Registry (1981–2013) were linked with 2000 United States Census data. Early (localized) and advanced (regional and distant) stage at diagnosis was assessed by age, race, ethnicity, neighborhood socioeconomic-, marital-, and smoking- status. Univariate and multivariable logistic regression models were fit to identify factors associated with the risk of advanced cervical cancer stage at diagnosis. Adjusted odds ratios (aOR) and corresponding 95{\%} confidence intervals (95{\%}CI) were calculated. Results: Of 18,279 women (meanage 51.3 years old), most were non-Hispanic (83.5{\%}), white (79.1{\%}), middle-low neighborhood socioeconomic status (NSES) (34.7{\%}), married (46.0{\%}), and never smoked (56.0{\%}). Higher odds of advanced stage was observed for blacks (aOR: 1.42, 95{\%}CI: 1.30–1.55, p < 0.001) compared to whites, Hispanics (1.15, 1.06–1.25, p = 0.001) compared to non-Hispanics, and middle-low (1.13, 1.02–1.25, p = 0.02) and low NSES (1.42, 1.28–1.57, p < 0.001) compared to high NSES. Previously (1.30, 1.21–1.39, p < 0.001) and never married (1.37, 1.27–1.48, p < 0.001) had higher odds of presenting with advanced stage versus married women. Never smokers had decreased odds of presenting with advanced stage compared to women with history of (1.41, 1.32–1.52, p < 0.001) or current (1.29, 1.18-1.42, p < 0.001)smoking status. Conclusions: There are cancer disparities in women of black race, Hispanic ethnicity and of middle-low and lowest NSES in Florida. Evidence-based interventions targeting these vulnerable groups are needed. Abbreviations: HPV: Human Papilloma Virus; CDC: Center for Disease Control and Prevention; SES: socioeconomic status; FCDS: Florida Cancer Data System; NSES: Neighborhood Socioeconomic Status; NPCR: National Program of Cancer Registries; IRB: Institutional Review Board; ACS: American Community Survey; SEER: Surveillance, Epidemiology and End Results; OR: Odds Ratio; CI: Confidence Interval",
keywords = "cancer stage, Cervical cancer, disparities, ethnicity, Florida, race",
author = "Aliyah Gauri and Sarah Messiah and Bouzoubaa, {Layla A.} and Moore, {Kevin J.} and Tulay Sengul",
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N2 - Objective: Florida has one of the highest cervical cancer mortality rates and socioeconomically diverse populations in the United States. We used statewide population-based cancer registry data to assess disparities in cervical cancer stage at diagnosis. Design: Primary invasive adult female cervical cancer patients in the Florida Cancer Data Registry (1981–2013) were linked with 2000 United States Census data. Early (localized) and advanced (regional and distant) stage at diagnosis was assessed by age, race, ethnicity, neighborhood socioeconomic-, marital-, and smoking- status. Univariate and multivariable logistic regression models were fit to identify factors associated with the risk of advanced cervical cancer stage at diagnosis. Adjusted odds ratios (aOR) and corresponding 95% confidence intervals (95%CI) were calculated. Results: Of 18,279 women (meanage 51.3 years old), most were non-Hispanic (83.5%), white (79.1%), middle-low neighborhood socioeconomic status (NSES) (34.7%), married (46.0%), and never smoked (56.0%). Higher odds of advanced stage was observed for blacks (aOR: 1.42, 95%CI: 1.30–1.55, p < 0.001) compared to whites, Hispanics (1.15, 1.06–1.25, p = 0.001) compared to non-Hispanics, and middle-low (1.13, 1.02–1.25, p = 0.02) and low NSES (1.42, 1.28–1.57, p < 0.001) compared to high NSES. Previously (1.30, 1.21–1.39, p < 0.001) and never married (1.37, 1.27–1.48, p < 0.001) had higher odds of presenting with advanced stage versus married women. Never smokers had decreased odds of presenting with advanced stage compared to women with history of (1.41, 1.32–1.52, p < 0.001) or current (1.29, 1.18-1.42, p < 0.001)smoking status. Conclusions: There are cancer disparities in women of black race, Hispanic ethnicity and of middle-low and lowest NSES in Florida. Evidence-based interventions targeting these vulnerable groups are needed. Abbreviations: HPV: Human Papilloma Virus; CDC: Center for Disease Control and Prevention; SES: socioeconomic status; FCDS: Florida Cancer Data System; NSES: Neighborhood Socioeconomic Status; NPCR: National Program of Cancer Registries; IRB: Institutional Review Board; ACS: American Community Survey; SEER: Surveillance, Epidemiology and End Results; OR: Odds Ratio; CI: Confidence Interval

AB - Objective: Florida has one of the highest cervical cancer mortality rates and socioeconomically diverse populations in the United States. We used statewide population-based cancer registry data to assess disparities in cervical cancer stage at diagnosis. Design: Primary invasive adult female cervical cancer patients in the Florida Cancer Data Registry (1981–2013) were linked with 2000 United States Census data. Early (localized) and advanced (regional and distant) stage at diagnosis was assessed by age, race, ethnicity, neighborhood socioeconomic-, marital-, and smoking- status. Univariate and multivariable logistic regression models were fit to identify factors associated with the risk of advanced cervical cancer stage at diagnosis. Adjusted odds ratios (aOR) and corresponding 95% confidence intervals (95%CI) were calculated. Results: Of 18,279 women (meanage 51.3 years old), most were non-Hispanic (83.5%), white (79.1%), middle-low neighborhood socioeconomic status (NSES) (34.7%), married (46.0%), and never smoked (56.0%). Higher odds of advanced stage was observed for blacks (aOR: 1.42, 95%CI: 1.30–1.55, p < 0.001) compared to whites, Hispanics (1.15, 1.06–1.25, p = 0.001) compared to non-Hispanics, and middle-low (1.13, 1.02–1.25, p = 0.02) and low NSES (1.42, 1.28–1.57, p < 0.001) compared to high NSES. Previously (1.30, 1.21–1.39, p < 0.001) and never married (1.37, 1.27–1.48, p < 0.001) had higher odds of presenting with advanced stage versus married women. Never smokers had decreased odds of presenting with advanced stage compared to women with history of (1.41, 1.32–1.52, p < 0.001) or current (1.29, 1.18-1.42, p < 0.001)smoking status. Conclusions: There are cancer disparities in women of black race, Hispanic ethnicity and of middle-low and lowest NSES in Florida. Evidence-based interventions targeting these vulnerable groups are needed. Abbreviations: HPV: Human Papilloma Virus; CDC: Center for Disease Control and Prevention; SES: socioeconomic status; FCDS: Florida Cancer Data System; NSES: Neighborhood Socioeconomic Status; NPCR: National Program of Cancer Registries; IRB: Institutional Review Board; ACS: American Community Survey; SEER: Surveillance, Epidemiology and End Results; OR: Odds Ratio; CI: Confidence Interval

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