ASPO Abstracts
Cervical cancer incidence and mortality in non-Hispanic African American and White women, United States, 1999-2015
Category: Cancer Health Disparities
Conference Year: 2020
Abstract Body:
Background:
Cervical cancer has disproportionately affected African American women in the United States
(US). To understand the burden of cervical cancer, we assessed incidence and mortality rates
and analyzed trends over time among non-Hispanic African American and White women in the
US from 1999 to 2015.
Methods:
We obtained cervical cancer incidence and mortality data from 1999 to 2015 from the Centers for
Disease Control and Prevention’s (CDC) publicly available online database, WONDER. From
age-adjusted incidence and mortality data, we calculated rate ratios (RR) and 95% confidence
intervals (CI) to evaluate differences by race. We analyzed incidence and mortality trends using
joinpoint regression. We used a log-linear model and interpreted trends in terms of a rate change
at a constant percent per year through annual percent change (APC) and average annual percent
change (AAPC). We limit our analyses to non-Hispanic African American and White women.
Results:
From 1999 to 2015, incidence rates for cervical cancer were significantly higher (RR: 1.46; 95%
CI: 1.44, 1.47) among African American (10.8 per 100,000 females) than White (7.4 per 100,000
females) women. Similarly, mortality rates were significantly higher (RR: 2.05; 95% CI: 2.01, 2.09)
in African American (4.4 per 100,000 females) compared to White (2.1 per 100,000 females)
women. During this period of 17 years, the overall incidence trend for cervical cancer decreased
significantly for both races, but the mortality trend only decreased significantly for African
American women (AAPC: -2.9; 95% CI: -4.1, -1.7). Mortality rates increased with age for both
races. In contrast, incidence rates increased for African American women, while decreasing for
White women as age increased.
Discussion:
African American women had a significantly higher cervical cancer incidence and mortality rate
than White women. Even as incidence and mortality trends declined significantly, older African
American women had three times the rate of cervical cancer than White women. Cervical cancer
prevention and treatment programs should be evaluated to identify gaps, particularly for African
American women, to ultimately reduce disparities in both incidence and mortality.
Keywords: cancer epidemiology; cervical cancer; racial disparities; trend analysis