Corrected mortality rates for cervical cancer indicate a greater disparity between races, according to a report in Cancer.
Because previous estimates did not adjust for women who’d had a hysterectomy or who were otherwise not at risk for cervical cancer, investigators performed a “corrected” analysis using data from the Behavioral Risk Factor Surveillance System and from the National Center for Health Statistics and the National Cancer Institute’s Surveillance, Epidemiology, and End Results program, for the years 2002 through 2012.
The corrected mortality rate in black women is 10.1 per 100,000 women (95% confidence interval, 9.6-10.6) and 4.7 per 100,000 in white women (95% CI, 4.6-4.8), an overall difference of 44%. The previous, uncorrected mortality rate for black women was 5.7 per 100,000 (95% CI, 5.5-6.0) and 3.2 per 100,000 (95% CI, 3.1-3.2) for white women, reported Anne F. Rositch, PhD, of Johns Hopkins Bloomberg School of Public Health, Baltimore, and her colleagues.
The corrected findings do not indicate a rise in the overall cervical cancer death rate, but do show that the disparity between the races is higher, despite declines in such deaths among black women over the years: The corrected analysis over the decade showed that the rate of decrease in cervical cancer mortality rates was 0.8% in white women and 3.6% in black women (P less than .05), Dr. Rositch and her associates reported (Cancer 2017 Jan 23 doi: 10.1002/cncr.30507 ). Both corrected and uncorrected rates were significantly higher in older black women, especially those 85 years and older at 18.6 per 100,000 (95% CI, 15.4-21.7) before correction, and 37.2 per 100,000 (95% CI, 31.0-43.5) after correction.
“Future research should focus on overcoming the underlying factors that contribute to this mortality gap (differential follow-up for abnormal Papanicolaou test results and barriers to care after diagnosis) and on determining why black women and older women receive different and inadequate treatment for the same disease,” wrote Dr. Rositch and her colleagues.
The elimination of mortality differences across the two races in women aged 20-29 years and those 35-39 years was “encouraging … because these age cohorts correspond to the patients who are most likely to have been vaccinated against the human papillomavirus (HPV) virus,” Heather J. Dalton, MD, and John Farley, MD, of Creighton University School of Medicine at St. Joseph’s Hospital and Medical Center, Phoenix, Ariz., wrote in an accompanying editorial (Cancer 2017 Jan. 23 doi: 10.1002/cncr.30501).
High-risk HPV infections and lack of adequate screening are the “only factors definitely associated with the incidence of cervical cancer,” they noted.
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