Introduction: The incidence and mortality of cervical cancer in the United States has decreased over the last four decades given screening and vaccination programs. Nevertheless, this statement cannot be generalized among all races. We investigated cancer-related mortality (CRM) and non-cancer related mortality (NCM) for cervical cancer patients among racial groups.
Methods: Women diagnosed with cervical cancer from 1990-2014 were identified from the Surveillance, Epidemiology and End Results database. Racial disparities in survival for non-Hispanic white (NHW), non-Hispanic black (NHB), Hispanic (HSP), and Asian/Pacific Islander (API) patients were compared using a competing risk model that accounted for both CRM and NCM. Analyses were particularly performed by histologic subtype for squamous cell carcinoma (SCC) vs. adenocarcinoma and adenosquamous carcinoma (AC/ASC).
Results: 62,887 cervical patients were analyzed: 34,520 (54.8%) NHW, 8,650 (13.8%) NHB, 13,937 (22.2%) HSP, and 5,780 (9.2%) API. From 1990 to 2014, the proportion of SCC has decreased, while the proportion of AC/ASC has increased among all racial groups with the exception of NHB patients who saw a smaller increase in AC/ASC (P<.0001). NHB patients were more likely to be diagnosed at advanced stages, and upon adjusting for known prognostic factors, NHB patients had the worst CRM and NCM among all racial groups (P<.0001). HSP patients had better CRM for both SCC and AC/ASC (P<.0001), whereas API patients had worse CRM for AC/ASC (P<.0001) when compared to NHW patients.
Conclusions: Both CRM and NCM significantly vary among racial groups, with the worst survival being seen in NHB patients.
Citation Format: Ying Huang, Christopher Tarney, Chunqiao Tian, Nicholas Bateman, Thomas Conrads, Chad Hamilton, George Maxwell, Kathleen Darcy. Disparities in cervical cancer patients by race and histology [abstract]. In: Proceedings of the Tenth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2017 Sep 25-28; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2018;27(7 Suppl):Abstract nr A51.