UM Study Finds Late Diagnosis And Under-Treatment To Blame For Disparities In Cervical Cancer Survival

Main Category: Cervical Cancer / HPV Vaccine
Also Included In: Cancer / Oncology;  Women's Health / Gynecology
Article Date: 25 Nov 2008 - 1:00 PST

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Disparities in cervical cancer survival can be traced to differences in access to care for certain racial, ethnic and socioeconomic groups, according to a University of Miami Miller School of Medicine study of more than 5,300 Florida women. A team of researchers at the Miller School found that racial, ethnic and socioeconomic factors led to late-stage diagnosis and under-treatment of the disease, especially for women who are African-American or poor.

The results indicate that strategies that aim to reduce disparities in cervical cancer survival should be focused on improved screening and treatment. The findings are published online in CANCER, a peer-reviewed journal of the American Cancer Society.

Despite recent efforts to equalize care for all patients, disparities in cancer survival remain a considerable problem. Kathleen Brookfield, M.D., Ph.D. led a team of Miller School physicians and scientists who analyzed data from a large Florida cancer registry, in the hopes of pinpointing criteria that lead to the disparity. The researchers identified 5,367 residents diagnosed with invasive tumors of the cervix between 1998 and 2003.

In this group of patients, Hispanic and Caucasian women had significantly longer survival times (52.8 months and 47.1 months, respectively) than African American women (28.8 months). Insured patients also lived longer than uninsured patients (63 months versus 41.2 months), as did patients from more affluent communities compared with patients in locations where more than 15 percent of patients live in poverty (53.3 months versus 36.9 months).

The investigators found that African Americans had significantly more early- and late-stage cancer compared with their Caucasian counterparts. African American women also were significantly less likely to have surgical treatment with the intent to cure their disease. However, in patients who did undergo surgery, or chemotherapy/radiation, race alone did not significantly impact survival. When socioeconomically disadvantaged women with invasive cervical cancer were treated appropriately for their stage of disease, adds Brookfield, "their survival outcomes were no different from those of women from more affluent communities."

Only insurance status, tumor characteristics, and treatment modality were associated with patient survival in the individuals studied in this analysis. Neither race, ethnicity, nor socioeconomic status were independent predictors of poorer outcomes for patients. "Earlier diagnosis and greater access to surgery, chemotherapy and radiation,' says Brookfield, "could significantly improve cervical cancer survival."

Source
Lisa Worley
Office of Communications
University of Miami Miller School of Medicine
http://www.med.miami.edu