Racial and ethnic disparities in the incidence of invasive cervical cancer in Florida.

BACKGROUND

Although cervical cancer incidence has declined in the past decade, considerable racial and ethnic differences remain. The objective of this study was to examine differences in incidence by histology and cancer stage in Florida stratified further by race, ethnicity, and 5-year time intervals.

METHODS

Women who were diagnosed with invasive cervical cancer in Florida between January 1985 and December 2004 were included in the analysis. Age-adjusted incidence rates by race and ethnicity were estimated for different histologic types and stages of cancer. The annual percentage of change in incidence also was calculated for each histologic type. Rate ratios were estimated by race and ethnicity using whites and non-Hispanics as the reference group.

RESULTS

Overall, the incidence in Florida of cervical squamous cell carcinoma and transitional cell carcinoma declined significantly from 9.1 per 100,000 women in 1985 to 5.6 per 100,000 women in 2004 (P < .05), whereas the incidence of cervical adenocarcinoma remained stable (P > .05). The incidence of invasive cervical cancer was 9.6 per 100,000 women among whites and 13.13 per 100,000 women among African Americans from 2000 to 2004. African-American women were nearly 2 times more likely to be diagnosed at regional and distant cancer stages than white women for all periods examined. Furthermore, among African-American women aged >40 years, the age-specific incidence of invasive cervical cancer increased considerably, whereas the rates among other racial groups decreased.

CONCLUSIONS

The increasing rate of invasive cervical cancer among African-American women aged >40 years in Florida, coupled with their diagnosis at a later stage of cancer, is of great concern. Most screening organizations recommend stopping screening at age 65 years. The observations from these analyses highlighted the need to focus prevention and screening efforts on African-American women living in Florida, and particularly on women of postreproductive age.