Department of Radiation Oncology, Cancer Therapy & Research Center, University of Texas Health Science Center San Antonio, San Antonio, TX, 78229, USA.
J Racial Ethn Health Disparities. 2017 Apr;4(2):165-168. doi: 10.1007/s40615-016-0214-3. Epub 2016 Mar 11.
Despite an overall improvement in cervical cancer screening, incidence, and mortality rates for minorities in the USA, regional differences in screening and stage at presentation have been observed. This study evaluated cervical cancer disparities in a predominately Hispanic population treated in a major treatment center in San Antonio, Texas.
Data on 446 patients with cervical cancer treated between 2000 and 2011 at the Cancer Therapy and Research Center in San Antonio, Texas, were reviewed. Sufficient information was obtained on 319 patients and was compared with the Surveillance, Epidemiology, and End Results (SEER) data.
Of 319 patients treated for cervical cancer between 2000 and 2011, 209 were Hispanics and 110 were Whites (82), Blacks (20), Asians (7), and others (1). The median and mean ages at diagnosis were 47 and 49, respectively. Only 36 % were known to have screening Pap tests prior to diagnosis, of which only 24 had yearly Pap tests. Forty-two patients (20 %) of those with no known screening Pap tests presented with stage IV disease at diagnosis (vs. 3 % of those with known Pap tests). Among the Hispanics, 68 % presented with regional disease (vs. 37 % SEER) and 46 % were stage III or higher disease, with stage IIIB accounting for 30 % of total. Although the overall age-adjusted death rates were higher in Hispanics due to a higher percentage of more advanced disease, survival rates appear similar, stage for stage, to the SEER data.
Even in a major city, Hispanics often present with more advanced cervical cancer than the general population. In order to minimize the cervical cancer disparities, efforts and strategies are needed to study the cultural and locale effects and to implement preventive measures and adaptive health education.
尽管美国少数民族的宫颈癌筛查、发病率和死亡率总体上有所改善，但仍观察到筛查和就诊时分期方面存在地区差异。本研究评估了德克萨斯州圣安东尼奥市一家主要治疗中心治疗的以西班牙裔为主的人群中的宫颈癌差异。
对 2000 年至 2011 年期间在德克萨斯州圣安东尼奥市癌症治疗与研究中心治疗的 446 例宫颈癌患者的数据进行了回顾。对 319 例患者获得了足够的信息，并与监测、流行病学和最终结果（SEER）数据进行了比较。
在 2000 年至 2011 年间治疗的 319 例宫颈癌患者中，209 例为西班牙裔，110 例为白人（82 例）、黑人（20 例）、亚洲人（7 例）和其他人（1 例）。诊断时的中位和平均年龄分别为 47 和 49 岁。仅 36%的患者已知在诊断前进行了筛查巴氏涂片检查，其中只有 24 人进行了每年一次的巴氏涂片检查。在没有已知筛查巴氏涂片检查的 42 例患者中，有 42 例（20%）在诊断时患有 IV 期疾病（而在已知巴氏涂片检查的患者中，这一比例为 3%）。在西班牙裔患者中，68%的患者出现局部疾病（SEER 为 37%），46%的患者为 III 期或更高期别疾病，其中 IIIB 期占总病例的 30%。尽管由于更多晚期疾病的百分比较高，西班牙裔患者的总体年龄调整死亡率更高，但生存率似乎与 SEER 数据相似，按分期计算。
即使在主要城市，西班牙裔患者的宫颈癌就诊时也往往比一般人群更晚期。为了最大限度地减少宫颈癌差异，需要努力和制定策略来研究文化和地方影响，并实施预防措施和适应性健康教育。
