Holt Hunter K, Calip Gregory S, Peterson Caryn E, David Shannon MacLaughlan, Geller Stacie, Guadamuz Jenny S
Department of Family and Community Medicine, University of Illinois Chicago, 1919 W. Taylor Street, Room 196, Chicago, IL, 60612, USA.
Department of Clinical Pharmacy, University of Southern California, Los Angeles, CA, USA.
Cancer Causes Control. 2025 Jun;36(6):595-604. doi: 10.1007/s10552-025-01961-0. Epub 2025 Jan 23.
Older Black women and women living in areas of low socioeconomic status (SES) diagnosed with cervical cancer (CC) have worse overall survival (OS). The objective was to investigate associations between OS and race/ethnicity and sociodemographic factors in younger (21-64 years) and older women (≥ 65 years) diagnosed with CC using Surveillance, Epidemiology, and End Results Program data.
This retrospective, population-based cohort study included 39,000 women ≥ 21 years diagnosed with CC diagnosed between 2006 and 2020. Age-group stratified Cox proportional hazards models adjusted for age, diagnosis year, and histology examined sociodemographic (rurality, SES, and persistent poverty) differences in OS.
In the sample, 82.8% were < 65 years. Compared to younger women, older women were more likely to be non-Latinx (NL) Black (16.0 vs 12.9%) and diagnosed with late-stage CC (67.9 vs 47.5%). Adjusted models suggested younger NL Black women had worse OS than their NL White counterparts (HR 1.45 [95% CI 1.37-1.54]), this association was not found among older NL Black women (HR 1.06 [95% CI 0.96-1.16]). Similarly, younger women in lowest SES areas had worse OS compared to women in highest SES areas (HR 1.82 [95% CI 1.69-1.96]), this association was attenuated in older women (HR 1.27 [95% CI 1.15-1.42]). Finally, younger women living in persistent poverty had worse OS compared to those who did not (HR 1.40 [95% CI 1.32-1.48]), this association was not found in older women (HR 1.10 [95% CI 0.99-1.21]).
Sociodemographic disparities were found in CC OS for women < 65 that were attenuated or nonexistent in women ≥ 65 years.
被诊断为宫颈癌（CC）的老年黑人女性以及生活在社会经济地位（SES）较低地区的女性总体生存率（OS）较差。本研究的目的是利用监测、流行病学和最终结果计划的数据，调查年龄在21至64岁的年轻女性和年龄≥65岁的老年女性中，总体生存率与种族/民族以及社会人口学因素之间的关联。
这项基于人群的回顾性队列研究纳入了2006年至2020年间被诊断为CC的39000名年龄≥21岁的女性。按年龄组分层的Cox比例风险模型对年龄、诊断年份和组织学进行了调整，以研究总体生存率在社会人口学（农村地区、SES和持续贫困）方面的差异。
在样本中，82.8%的女性年龄<65岁。与年轻女性相比，老年女性更有可能是非拉丁裔（NL）黑人（16.0%对12.9%），并且被诊断为晚期CC（67.9%对47.5%）。调整后的模型表明，年轻的NL黑人女性的总体生存率比NL白人女性差（风险比[HR]1.45[95%置信区间（CI）1.37 - 1.54]），而在老年NL黑人女性中未发现这种关联（HR 1.06[95%CI 0.96 - 1.16]）。同样，与SES最高地区的女性相比，SES最低地区的年轻女性总体生存率较差（HR 1.82[95%CI 1.69 - 1.96]），这种关联在老年女性中减弱（HR 1.27[95%CI 1.15 - 1.42]）。最后，与未处于持续贫困状态的女性相比，处于持续贫困状态的年轻女性总体生存率较差（HR 1.40[95%CI 1.32 - 1.48]），在老年女性中未发现这种关联（HR 1.10[95%CI 0.99 - 1.21]）。
在年龄<65岁的女性宫颈癌总体生存率中发现了社会人口学差异，而在年龄≥65岁的女性中这种差异减弱或不存在。
