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Social determinants of health, such as poverty, race and ethnicity, and access to treatment, play a significant role in cervical cancer rates across the United States, according to an analysis presented at an international conference. It was revealed. 2024 SGO Annual Meeting on Women's Cancer.1
Additionally, the burden of recurrent or metastatic cervical cancer may increase health care disparities in this patient population, according to the results of the geographic analysis.
This analysis also showed that areas with higher proportions of low-income households were significantly associated with reduced screening (P <.001) and higher cervical cancer burden (P <.001). Additionally, poverty level was significantly associated with the burden of recurrent/metastatic cervical cancer in the South (P <.003).
“The findings from this study are [are] A first step in advocating for optimizing health resource allocation and minimizing access barriers. [tailor] “Educate U.S. patients about the latest treatment options to minimize disparities in outcomes,” study author Tara Castellano, M.D., and colleagues said in a presentation of the data.
Castellano is an assistant professor in the Department of Gynecologic Oncology at Louisiana State University in New Orleans.
Researchers develop the Cervical Cancer Geoanalyzer tool to help researchers, policy makers, and advocacy groups identify geographic areas with high need for cervical cancer education and health resources. Did. This open-access, web-based, interactive tool is designed to help visualize the burden of cervical cancer and recurrent/metastatic cervical cancer across different regions of the United States.2
Previous research utilizing tools published in gynecological oncology analyzed the burden of recurrent/metastatic cervical cancer across 410 metropolitan statistical areas (MSAs) in 2023. Findings showed that this burden varied across MSAs (range, 0% to 83.3%). Furthermore, in Boston-Cambridge-Newton, Massachusetts, the recurrent/metastatic burden increased from 41% in 2018 to 50% in 2020, and in Sacramento-Roseville-Arden-Arcade, California, from 33% in 2018 to 2020. Increased to 50%. Conversely, in Grand Rapids, Michigan, this burden decreased from 55% in 2018 to 31% in 2020, and in San Francisco-Oakland-Hayward, California, it decreased from 40% in 2018 to 26% in 2020.3
This analysis, presented at the 2024 SGO Annual Meeting on Women's Cancer, will enable researchers to further understand the factors associated with observed cervical cancer incidence in different geographic regions. was aimed at.1
The researchers defined cervical cancer burden as common diagnoses per 100,000 enrollees and recurrence/metastatic burden as the proportion of cervical cancer patients who started systemic therapy. To be eligible for screening data, women had to have had a cervical cytology test within the past 3 years and be between the ages of 21 and 64. Be between 30 and 64 years of age and have had a cervical high-risk human papillomavirus (hrHPV) test within the past 5 years. or are between 30 and 64 years old and have had a cervical cytology/hrHPV test within the past 5 years.
The study used administrative claims databases to identify more than 165 million U.S. patients and researchers investigated the prevalence of cervical cancer, the incidence of recurrent/metastatic disease, and the We looked at the number of women tested in different regions based on the first three digits of the number. Postal code (ZIP-3).
Data from the U.S. Census Bureau's American Community Survey were used to categorize poverty level and race/ethnicity. Poverty level was defined as a household with income below her 200% of the federal poverty limit. Additionally, information from the American Brachytherapy Association was used to identify brachytherapy centers according to ZIP-3.
This study aimed to visualize the geographic distribution of cervical cancer and recurrent/metastatic cervical cancer in the United States. Additionally, researchers sought to quantify the association between the burden of cervical cancer and recurrent/metastatic cervical cancer and screening rates, poverty level, race/ethnicity, and access to brachytherapy. I tried.
Researchers identified 75,521 patients with cervical cancer with a median age of 53 years (IQR, 42-63 years). Insurance types included commercial insurance (70%), Medicaid insurance (29%), and other (1%). 21% of patients were in the Midwest, 22% in the Northeast, 37% in the South, 19% in the West, and 1% other/unknown.
Additionally, 14,033 patients with recurrent/metastatic cervical cancer were identified, with a median age of 59 years (IQR, 49-66 years). Insurance types included commercial insurance (73%), Medicaid insurance (26%), and other (1%). Regional breakdown includes Midwest (21%), Northeast (22%), South (37%), West (19%), and Other/Unknown (1%).
Additional data showed that higher screening rates were significantly associated with reduced cervical cancer burden only in the South (P <.001). In the Midwest, higher screening rates were associated with lower recurrence/metastasis burden (P <.05) and south (P <.05); however, they were associated with a higher recurrent/metastatic burden in the West (P <.05).
Regarding the association between race/ethnicity and cervical cancer burden, a significant association was observed between increasing racial/ethnic proportions of Hispanic patients and increasing cervical cancer burden in all regions. I did. Black patients in the Midwest. Black patients in the Northeast. and Southern white patients. Conversely, a significant association between increasing racial/ethnic proportions and decreasing cervical cancer burden was observed among Asian patients in all regions. Midwestern white patients. Other patients in the Midwest. Black patients in the South. and Western white patients.
Regarding the burden of recurrent/metastatic cervical cancer, a significant association between increasing race/ethnicity and decreasing burden was found only among Midwestern Asian patients.
Additionally, the presence of at least one brachytherapy center within ZIP-3 was associated with a 2.7% lower burden of recurrent or metastatic cervical cancer (20.7% vs. 23.4%; P <.001). Notably, this reduction was driven by significant connections between the South and Midwest (P <.001).
disclosure: Dr. Castellano reported receiving consulting fees from GSK and Nykode. Receives grant support from Bristol-Myers Squibb.
