Elhussin Isra, Nganwa David, Peaster Ronald, Egiebor-Aiwan Oyoyo, James Crystal M, Heath John, Webb Lecarde, Abdalla Ehsan
Department of Biology Center for Cancer Research College of Arts and Sciences (CAS) Tuskegee University.
Department of Pathobiology/Department of Graduate Public Health College of Veterinary Medicine Tuskegee University.
J Healthc Sci Humanit. 2020 Fall;10(1):61-83.
There are disparities in cervical cancer treatment options between African American (Black) and White women in Alabama. The objective of this study was to identify and assess factors contributing to the prevailing inequalities in cervical cancer treatment options between Blacks and Whites, who are living in urban, rural Black Belt (BB), and other rural counties of Alabama. The data of our study population, which was comprised of 2,124 cases of cervical cancer in women 17 years and older, were extracted from the 2004 to 2013 dataset of the Alabama Department of Public Health (ADPH) Cancer Registry. For the analysis of frequency distributions, chi-square, and logistic regression tests SAS software was used. Racial disparities in cervical cancer treatment options for Blacks living within the same counties as Whites still exist. The study analysis showed that younger Blacks living in urban counties with advanced stages of cervical cancer were more likely to receive radiation treatment options but were less likely to undergo surgical treatment options (-value <.0001). Younger Blacks living in the rural BB and other rural counties were mainly treated with radiation options for the early stages of cervical cancer (-value 0.001), while older ones received surgery options (-value <.0001), and combined therapy of surgery and radiation options (-value 0.05). When adjusted for age, stage of cancer, and county of residence, Blacks had 2.76 (95% CI 0.90-8.86) times the odds ratio of receiving immunotherapy options compared to Whites. Blacks had 0.74 (95% CI 0.58-0.95) times adjusted odds ratio of undergoing less surgery option compared to Whites. Our study findings suggest that cervical cancer treatment options and control interventions targeted towards disadvantaged women, particularly Blacks living in the rural BB and other rural counties have the potential to reduce and/or eradicate this preventable disease.
阿拉巴马州非裔美国（黑人）女性和白人女性在宫颈癌治疗选择上存在差异。本研究的目的是识别和评估造成居住在阿拉巴马州城市、农村黑带地区（BB）及其他农村县的黑人和白人在宫颈癌治疗选择上普遍存在不平等现象的因素。我们的研究人群数据来自阿拉巴马州公共卫生部（ADPH）癌症登记处2004年至2013年的数据集，包括2124例17岁及以上女性宫颈癌病例。对于频率分布、卡方检验和逻辑回归分析，使用了SAS软件。与白人居住在同一县的黑人在宫颈癌治疗选择上仍存在种族差异。研究分析表明，居住在城市县且处于宫颈癌晚期的年轻黑人更有可能接受放射治疗，但接受手术治疗的可能性较小（P值<.0001）。居住在农村BB地区和其他农村县的年轻黑人在宫颈癌早期主要接受放射治疗（P值0.001），而年长的黑人接受手术治疗（P值<.0001）以及手术和放射联合治疗（P值0.05）。在对年龄、癌症分期和居住县进行调整后，与白人相比，黑人接受免疫治疗的优势比为2.76（95%置信区间0.90 - 8.86）倍。与白人相比，黑人接受较少手术治疗的调整后优势比为0.74（95%置信区间0.58 - 0.95）倍。我们的研究结果表明，针对弱势女性，特别是居住在农村BB地区和其他农村县的黑人的宫颈癌治疗选择和控制干预措施有可能减少和/或根除这种可预防的疾病。
