Age and race disparities in cervical cancer diagnosis and treatment were found to be significant for both adenocarcinoma and squamous cell carcinoma between 2004 and 2017.
Among patients with cancer of the cervix, there are differences in treatment, diagnosis, and overall outcomes for patients with adenocarcinoma of the cervix (AC) compared to those with squamous cell carcinoma of the cervix (SCC). This article, published in the Journal of Lower Genital Tract Disease, compares these two types of cervical cancer to determine associations between stage at diagnosis and guideline-concordant treatment with race, age, and insurance type. This information can lead to a better understanding of how systemic factors related to race and other demographic factors can impact treatment and outcomes.
This study relied on data from a retrospective cohort study of cervical cancer. Data from a total of 18,811 patients with cervical AC and 68,421 with cervical SCC from the 2004-2017 National Cancer Database were used. The authors used linear models to evaluate trends in the frequency of histologies, as well as to evaluate associations between race, age, and insurance status with stage of diagnosis and receipt of treatment for AC and SCC.
Compared to SCC, women with AC were younger, more likely to be White, and more likely to be privately insured. Older women with AC were 44% less likely to be diagnosed with early-stage disease compared to younger women, but no significant difference was found for SCC. Black women with AC were found to be 16% less likely to receive diagnosis of early-stage disease compared to White women, and women with public insurance were likewise less likely to be diagnosed at an early stage for both AC and SCC. It was also found that the proportion of AC to SCC rose from 19.4% to 23.2%. The authors conclude that as this ratio continues to rise, race- and age-related disparities must be addressed in order to reduce excess morbidity and mortality.
Smith, A. J. B., Beavis, A. L., Rositch, A. F., & Levinson, K. (2023). Disparities in Diagnosis and Treatment of Cervical Adenocarcinoma Compared With Squamous Cell Carcinoma: An Analysis of the National Cancer Database, 2004-2017. Journal of Lower Genital Tract Disease, 27(1), 29-34. https://doi.org/10.1097/lgt.0000000000000702