Racial differences in 5-year relative survival rates of cervical cancer by stage at diagnosis, between African American (black) and white women, living in the state of Alabama, USA

Abstract

Background: Our objective was to assess racial differences in the 5-year relative survival rates (RSRs) of Cervical Cancer (CerCancer) by stage at diagnosis, between Black and White women, living in Alabama, USA.

Methods: Data for 3484 Blacks and 21,059 Whites diagnosed with CerCancer were extracted from the 2004 to 2013 Surveillance, Epidemiology, and End Results (SEER) database. We incorporated age groups, CerCancer stages, county, and year of diagnosis to compare the RSR between Blacks and Whites, using SEER*Stat software.

Results: In urban, Black Belt (BB) and other rural counties, Whites diagnosed with localized stage of CerCancer always had better chances of survival because their RSRs were always more than 77%, compared to Blacks. Only exception was in Blacks living in other rural counties, who had a significantly higher RSR of 83.8% (95% Cl, 74.2-90.1). Which was the same as in Whites (83.8% (95% CI 74.5-89.9) living in BBC. Although, in other rural counties, Whites had a slightly lower RSR of 83.7% (95% CI 79.9-86.8%), their RSR was better compared to Blacks and Whites living in BB and other rural counties who had slightly higher RSRs of 83.8%. This was due to statistical precision, which depended on their larger sample size and a lower variability therefore, more reliability resulting in a tighter confidence interval with a smaller margin of error. In all the three county groups, Whites 15-44 years old diagnosed with localized stage of CerCancer had a higher RSR of 93.6% (95% CI 91.4-95.2%) for those living in urban and BB counties, and 94.6% (95% CI 93.6-95.4) for those living in other rural counties. The only exception was in Blacks 65-74 years old living in other rural counties who had the highest RSR of 96.9% (95% Cl, 82.9-99.5). However, Whites were considered to have a better RSR. This was also due to the statistical precision as mentioned above.

Conclusion: There were significant racial differences in the RSRs of CerCancer. Overall, Black women experienced the worst RSRs compared to their White counterparts.

Keywords: 5-year relative survival ratios (RSRs); Black Belt and other rural counties of Alabama; Cervical cancer; Urban.

Fig. 1

Urban, rural Black Belt and other rural counties of Alabama. Urban Counties: Baldwin, Calhoun, Etowah, Houston, Jefferson, Lauderdale, Lee, Madison, Mobile, Montgomery, Morgan, Shelby, Tuscaloosa. Rural Black Belt Counties: Bullock, Choctaw, Dallas, Greene, Hale, Lowndes, Macon, Marengo, Perry, Pickens, Sumter, Wilcox. Other Rural Counties: Autauga, Barbour, Bibb, Blount, Butler, Chambers, Cherokee, Chilton, Clarke, Clay, Cleburne, Coffee, Colbert, Conecuh, Coosa, Covington, Crenshaw, Cullman, Dale, DeKalb, Elmore, Escambia, Fayette, Franklin, Geneva, Henry, Jackson, Lamar, Lawrence, Limestone, Marion, Marshall, Monroe, Pike, Randolph, Russell, St. Clair, Talladega, Tallapoosa, Walker, Washington, Winston

Fig. 2

5-year relative survival rates of cervical cancer in Blacks and Whites in Alabama. Urban. Black Belt. Other Rural

Fig. 3

5-year relative survival rates of cervical cancer in Blacks and Whites in urban counties. Blacks. Whites

Fig. 4

5-year relative survival rates of cervical cancer in Blacks and Whites in Black Belt counties. Blacks. Whites

Fig. 5

5-year relative survival rates of cervical cancer in Blacks and Whites in other rural counties. Blacks. Whites