Research Article
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Published Online: 6 November 2006

Cervical Cancer Survival by Socioeconomic Status, Race/Ethnicity, and Place of Residence in Texas, 1995–2001

Publication: Journal of Women's Health
Volume 15, Issue Number 8

Abstract

Objective: The current study explored whether socioeconomic status (SES), race/ethnicity, and rural residence may be linked to poorer cervical cancer survival by stage at diagnosis.
Methods: Data from 7,237 cervical cancer cases reported to the Texas Cancer Registry from 1995–2001 were used to address the association by stage at diagnosis and cause of death. Zip code-level census data were used to classify residence and to develop a composite variable for SES. Multilevel Cox proportional hazards modeling was used to estimate hazard ratios (HR) and 95% confidence intervals (CI).
Results: Late stage at diagnosis was a strong predictor of cervical cancer mortality (HR = 6.2, 95% CI 5.5-7.2). SES and race/ethnicity were independently associated with stage at diagnosis. Women residing in areas with lower SES had significantly shorter survival times when diagnosed at an early stage (HR = 3.0, 95% CI 2.1-4.3). Hispanic women had a lower probability of dying from cervical cancer during the follow-up period (HR = 0.7, 95% CI 0.6- 0.8) after adjusting for confounders. The association between lower SES and poorer survival was consistent across all racial/ethnic groups, suggesting the effect of SES may be more important than race
Conclusions: SES and race/ethnicity were independently associated with poorer cervical cancer survival in this large Texas sample. Further research is needed to investigate the role of optimal treatment and comorbid conditions in the association between SES and cervical cancer survival.

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cover image Journal of Women's Health
Journal of Women's Health
Volume 15Issue Number 8October 2006
Pages: 941 - 951
PubMed: 17087618

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Published online: 6 November 2006
Published in print: October 2006

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Katherine S. Eggleston
School of Public Health, University of Texas Health Science Center, Houston, Texas.
Ann L. Coker
School of Public Health, University of Texas Health Science Center, Houston, Texas.
Melanie Williams
Texas Department of State Health Services, Cancer Epidemiology and Surveillance Branch, Austin, Texas.
Guillermo Tortolero-Luna
School of Public Health, University of Texas Health Science Center, Houston, Texas.
Jeanne B. Martin
School of Public Health, University of Texas Health Science Center, Houston, Texas.
Susan R. Tortolero
School of Public Health, University of Texas Health Science Center, Houston, Texas.

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