Is the cervical cancer mortality rate underestimated?
A new study in Cancer indicates that the estimated rate of death from cervical cancer may be higher than previously thought.
Researchers used National Center for Health Statistics county mortality data, stratifying estimates of deaths from cervical cancer by age, state, year, and race. Data stratified the same way, on the prevalence of hysterectomy in women aged 20 years or older, were used to remove women who were not at risk from the denominator. They computed age-specific and age-standardized mortality rates and Joinpoint regression was used to analyze the trends in mortality rates.
Following correction, age-standardized rates of cervical cancer were higher for both white and black women. The uncorrected rate for black women was 5.7 per 100,000 (95% confidence interval [CI], 5.5 – 6.0), while the corrected rate was 10.1 per 100,000 (95% CI, 9.6 – 10.6). Among white women, the uncorrected rate was 3.2 per 100,000 (95% CI, 3.1 – 3.2) and an uncorrected rate of 4.7 per 100,000 (95% CI, 4.6 – 4.8). The difference between the races was underestimated by 44% without the correction. The highest corrected rate of 37.2 per 100,000 was found among black women aged 85 years or older. Following the correction, a trend analysis showed that white women’s rate of death had decreased by 0.8% per year while black women had an annual decrease of 3.6% (P < .05).
The investigators concluded that cervical cancer mortality has been underestimated overall and particularly in black women. They urged public health efforts to focus on encouraging appropriate screening and adequate treatment in older black women.