期刊
JOURNAL OF THE NATIONAL MEDICAL ASSOCIATION
卷 112, 期 6, 页码 632-638出版社
NATL MED ASSOC
DOI: 10.1016/j.jnma.2020.06.007
关键词
Cancer epidemiology; Cervical cancer; Incidence; Mortality; Racial disparitiess; Trend analysis
资金
- Centers for Disease Control and Prevention (CDC) [NU58DP005513]
- Office of Minority Health (OMH) [AIAMP120011]
- Indian Health Service (IHS) [U1B1IHS0009-13-00]
Background: Cervical cancer, a preventable cancer, has disproportionately affected African American women. To better understand the burden of cervical cancer, we assessed incidence and mortality rates and analyzed trends among non-Hispanic (NH) African American and White women in the US from 1999 to 2015. Methods: From age-adjusted cervical cancer incidence and mortality rates, rate ratios (RR) and 95% confidence intervals (CI) were calculated for comparison between the two races. Trends were analyzed using joinpoint regression and expressed as annual percent change (APC) and average annual percent change (AAPC). Results: Cervical cancer incidence rates were significantly higher (RR: 1.46: 95% CI: 1.44, 1.47) among NH African Americans (10.8 per 100.000 females) than NH Whites (7.4 per 100,000 females). Similarly, mortality rates were significantly higher (RR: 2.05; 95% CI: 2.01, 2.09) in NH African Americans (4.4 per 100,000 females) compared to NH whites (2.1 per 100,000 females). From 1999 to 2015, overall incidence and mortality trends decreased significantly for both races. Mortality rates steadily increased with age for both races, and incidence rates only increased with age in NH African American women. Conclusion: NH African American women had significantly higher cervical cancer incidence and mortality rates than NH Whites. Even as incidence and mortality trends declined significantly, older NH African Americans had three times the rate of cervical cancer than NH Whites. Prevention and treatment programs need to be enhanced for African Americans as failure to do so may widen cancer disparities.
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