Geographic poverty and racial/ethnic disparities in cervical cancer precursor rates in connecticut, 2008-2009

L.M. Niccolai, P.J. Julian, A. Bilinski, N.R. Mehta, J.I. Meek, D. Zelterman, J.L. Hadler and L. Sosa

American Journal of Public Health, 2013, vol. 103, issue 1, 156-163

Abstract: Objectives. We examined associations of geographic measures of poverty, race, ethnicity, and city status with rates of cervical intraepithelial neoplasia grade 2 or higher and adenocarcinoma in situ (CIN2+/AIS), known precursors to cervical cancer. Methods. We identified 3937 cases of CIN2+/AIS among women aged 20 to 39 years in statewide surveillance data from Connecticut for 2008 to 2009. We geocoded cases to census tracts and used census data to calculate overall and age-specific rates. Poisson regression determined whether rates differed by geographic measures. Results. The average annual rate of CIN2+/AIS was 417.6 per 100 000 women. Overall, higher rates of CIN2+/AIS were associated with higher levels of poverty and higher proportions of Black residents. Poverty was the strongest and most consistently associated measure. However, among women aged 20 to 24 years, we observed inverse associations between poverty and CIN2+/AIS rates. Conclusions. Disparities in cervical cancer precursors exist for poverty and race, but these effects are age dependent. This information is necessary to monitor human papillomavirus vaccine impact and target vaccination strategies. Copyright © 2012 by the American Public Health Association®.

Keywords: adenocarcinoma; adult; article; cancer grading; Caucasian; ethnic group; ethnology; female; geography; health care disparity; Hispanic; human; Negro; pathology; poverty; precancer; United States; uterine cervix carcinoma in situ; uterine cervix tumor, Adenocarcinoma; Adult; African Continental Ancestry Group; Cervical Intraepithelial Neoplasia; Connecticut; Ethnic Groups; European Continental Ancestry Group; Female; Geography; Healthcare Disparities; Hispanic Americans; Humans; Neoplasm Grading; Poverty; Precancerous Conditions; Uterine Cervical Neoplasms; Young Adult (search for similar items in EconPapers)
Date: 2013
References: Add references at CitEc
Citations:

Downloads: (external link)
http://hdl.handle.net/10.2105/AJPH.2011.300447

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:aph:ajpbhl:10.2105/ajph.2011.300447_3

DOI: 10.2105/AJPH.2011.300447

Access Statistics for this article

American Journal of Public Health is currently edited by Alfredo Morabia

More articles in American Journal of Public Health from American Public Health Association
Bibliographic data for series maintained by Christopher F Baum ().