Assessing Inequities in Cervical Cancer Quality of Care and Survival Related to Ethnicity and Socioeconomic Factors.
Adolescent
Adult
Aged
Aged, 80 and over
Cohort Studies
Databases, Factual
Ethnicity
Female
Guideline Adherence
Healthcare Disparities
/ statistics & numerical data
Hispanic or Latino
/ statistics & numerical data
Humans
Middle Aged
Quality of Health Care
Retrospective Studies
Socioeconomic Factors
Survival Rate
Treatment Adherence and Compliance
/ statistics & numerical data
United States
/ epidemiology
Uterine Cervical Neoplasms
/ epidemiology
White People
/ statistics & numerical data
Young Adult
Journal
Journal of lower genital tract disease
ISSN: 1526-0976
Titre abrégé: J Low Genit Tract Dis
Pays: United States
ID NLM: 9704963
Informations de publication
Date de publication:
01 Jul 2021
01 Jul 2021
Historique:
pubmed:
30
5
2021
medline:
20
11
2021
entrez:
29
5
2021
Statut:
ppublish
Résumé
This study aimed to assess the effect that race and socioeconomic factors have on the provision of care to cervical cancer patients based on National Comprehensive Cancer Network (NCCN) recommended treatment guidelines. To do this, we completed a retrospective cohort study using the American College of Surgeon's Nation Cancer Database from 2004 to 2016. We identified all reported cases of cervical cancer in that period. Two cohorts were created using self-reported racial demographic data, Hispanic- and White, non-Hispanic-identified patients. Our primary outcome variables were adherence to NCCN-recommended treatment and 5-year overall survival. Adherence to NCCN-recommended treatment was determined by the provision of surgical and/or radiation and/or chemotherapy treatment based on the clinical stage at time of diagnosis and the presence or absence of lymphovascular space invasion. We used bivariate analyses to compare baseline characteristics between the 2 cohorts, multivariable logistic regression to identify independent predictors of 5-year survival, and Cox proportional hazards models to compute survival by group. The difference in NCCN-adherent care between the 2 cohorts was found to be not statistically significant (p = .880). A log rank (Mantel-Cox) χ2 test showed that there was a statistically significant difference between the 2 groups in overall survival with the Hispanic-identified patients living longer (p < .001). Our study is limited by the effect large databases confer on finding statistical significance. Hispanic-identified women with cervical cancer receive NCCN-compliant care and live longer than their White, non-Hispanic counterparts.
Identifiants
pubmed: 34050109
doi: 10.1097/LGT.0000000000000611
pii: 00128360-202107000-00004
doi:
Types de publication
Comparative Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
205-209Informations de copyright
Copyright © 2021, ASCCP.
Déclaration de conflit d'intérêts
The authors have declared they have no conflicts of interest.
Références
Smedley BD, Stith AY, Nelson AR, eds. Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care . Washington, DC: National Academies Press; 2003.
Collins Y, Holcomb K, Chapman-Davis E, et al. Gynecologic cancer disparities: a report from the Health Disparities Taskforce of the Society of Gynecologic Oncology. Gynecol Oncol 2014;133:353–61.
Ibeanu OA, Díaz-Montes TP. Outcomes in ovarian cancer among hispanic women living in the United States: a population-based analysis. Patholog Res Int 2013;2013:672710.
Siegel RL, Miller KD, Jemal A. Cancer statistics, 2019. CA Cancer J Clin 2019;69:7–34.
American Cancer Society. Cancer Facts & Figures for Hispanics/Latinos 2018-2020 . Atlanta: American Cancer Society, Inc; 2018.
Chatterjee S, Gupta D, Caputo TA, et al. Disparities in gynecological malignancies. Front Oncol 2016;6:36. doi:10.3389/fonc.2016.00036.
doi: 10.3389/fonc.2016.00036
Garner EI. Cervical cancer: disparities in screening, treatment, and survival. Cancer Epidemiol Biomarkers Prev 2003;12:242s–7s.
Wharam JF, Zhang F, Xu X, et al. National trends and disparities in cervical cancer screening among commercially insured women, 2001–2010. Cancer Epidemiol Biomarkers Prev 2014;23:2366–73.
Koh WJ, Abu-Rustum NR, Bean S, et al. Cervical cancer, Version 3.2019, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw 2019;17:64–84.
Bristow RE, Chang J, Ziogas A, et al. Sociodemographic disparities in advanced ovarian cancer survival and adherence to treatment guidelines. Obstet Gynecol 2015;125:833–42.
Bray F, Ferlay J, Soerjomataram I, et al. Global Cancer Statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2018;68:394–424.
U.S. Cancer Statistics Working Group. U.S. Cancer Statistics Data Visualizations Tool, based on November 2018 submission data (1999–2016): U.S. Department of Health and Human Services, Centers for Disease Control and Prevention and National Cancer Institute. Available at: www.cdc.gov/cancer/dataviz . Released in June 2019. Accessed September 10, 2019.
Huang AB, Huang Y, Hur C, et al. Impact of quality of care on racial disparities in survival for endometrial cancer. Am J Obstet Gynecol 2020;223:396.e1–396.e13. doi:10.1016/j.ajog.2020.02.02.
doi: 10.1016/j.ajog.2020.02.02
Alimena S, Yang DD, Melamed A, et al. Racial disparities in brachytherapy administration and survival in women with locally advanced cervical cancer. Gynecol Oncol 2019;154:595–601.
Bruce SF, Joshi TV, Chervoneva I, et al. Disparities among cervical cancer patients receiving brachytherapy. Obstet Gynecol 2019;134:559–69.