Disparities in survival among women with invasive cervical cancer: A problem of access to care

Kathleen F. Brookfield, Michael C. Cheung, Joseph Lucci, Lora E. Fleming, Leonidas G. Koniaris

Research output: Contribution to journalArticle

65 Citations (Scopus)

Abstract

BACKGROUND: In this study, the authors sought to understand the effects of patient race, ethnicity, and socioeconomic status (SES) on outcomes for cervical cancer. METHOD: The Florida Cancer Data System and the Agency for Health Care Administration data sets (1998-2003) were merged and queried. Survival outcomes for patients with invasive cervical cancer were compared between different races, ethnicities, and community poverty levels. RESULTS: In total, 5367 patients with cervical cancers were identified. The overall median survival was 43 months. Significantly longer survival was observed for Caucasians (47.1 months vs 28.8 months for African Americans [AA]; P < .001), Hispanics (52.8 months vs 41.6 months for non-Hispanics; P < .001), the insured (63 months vs 41.2 months for uninsured; P < .001), and patients from more affluent communities (53.3 months where <5% lived in poverty vs 36.9 months where >15% lived in poverty; P < .001). Surgery was associated with dramatically improved survival. AA women who were diagnosed with cervical cancer were significantly less likely to undergo surgical treatment with curative intent compared with Caucasian women (P < .001). However, on multivariate analysis, independent predictors of poorer outcomes were insurance status, tumor stage, tumor grade, and treatment. Neither race, nor ethnicity, nor SES was an independent predictor of poorer outcome. CONCLUSIONS: Race, ethnic, and SES disparities in cervical cancer survival were explained by late-stage presentation and under-treatment. Earlier diagnosis and greater access to surgery and other treatments would significantly improve the survival of women with cervical cancer.

Original languageEnglish
Pages (from-to)166-178
Number of pages13
JournalCancer
Volume115
Issue number1
DOIs
StatePublished - Jan 1 2009
Externally publishedYes

Fingerprint

Uterine Cervical Neoplasms
Survival
Social Class
Poverty
African Americans
Neoplasms
Insurance Coverage
Therapeutics
Information Systems
Early Diagnosis
Multivariate Analysis
Delivery of Health Care

Keywords

  • Health disparities
  • Poverty
  • Socioeconomic status
  • Women's health

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Brookfield, K. F., Cheung, M. C., Lucci, J., Fleming, L. E., & Koniaris, L. G. (2009). Disparities in survival among women with invasive cervical cancer: A problem of access to care. Cancer, 115(1), 166-178. https://doi.org/10.1002/cncr.24007

Disparities in survival among women with invasive cervical cancer : A problem of access to care. / Brookfield, Kathleen F.; Cheung, Michael C.; Lucci, Joseph; Fleming, Lora E.; Koniaris, Leonidas G.

In: Cancer, Vol. 115, No. 1, 01.01.2009, p. 166-178.

Research output: Contribution to journalArticle

Brookfield, KF, Cheung, MC, Lucci, J, Fleming, LE & Koniaris, LG 2009, 'Disparities in survival among women with invasive cervical cancer: A problem of access to care', Cancer, vol. 115, no. 1, pp. 166-178. https://doi.org/10.1002/cncr.24007
Brookfield KF, Cheung MC, Lucci J, Fleming LE, Koniaris LG. Disparities in survival among women with invasive cervical cancer: A problem of access to care. Cancer. 2009 Jan 1;115(1):166-178. https://doi.org/10.1002/cncr.24007
Brookfield, Kathleen F. ; Cheung, Michael C. ; Lucci, Joseph ; Fleming, Lora E. ; Koniaris, Leonidas G. / Disparities in survival among women with invasive cervical cancer : A problem of access to care. In: Cancer. 2009 ; Vol. 115, No. 1. pp. 166-178.
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