Hysterectomy-Corrected Cervical Cancer Mortality Rates Reveal a Larger Racial Disparity in the United States
Hysterectomy-Corrected Cervical Cancer Mortality Rates Reveal a Larger Racial Disparity in the United States
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DOI：
10.1002/cncr.30507
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发表时间：
2017-03-15
期刊：
影响因子：
6.2
通讯作者：
Rositch, Anne F.
中科院分区：
文献类型：
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作者：
Beavis, Anna L.;Gravitt, Patti E.;Rositch, Anne F.
背景：本研究的目的是确定校正子宫切除术流行率后的年龄标准化和年龄特异性美国宫颈癌年死亡率，并评估年龄和种族的差异。方法：根据国家卫生统计中心（National Center for Health Statistics）的县死亡率数据（2000-2012），按年龄、州、年份和种族分层估计宫颈癌死亡。从行为风险因素监测系统调查中获得的20岁及以上女性子宫切除术流行率的同等分层数据被用于将无风险的女性从分母中剔除。计算特定年龄死亡率和年龄标准化死亡率，并采用关节点回归分析死亡率趋势。结果：校正后两个种族的年龄标准化率均较高。对于黑人妇女，校正后的死亡率为10.1 / 10万（95%置信区间[CI]， 9.6-10.6），而未校正的死亡率为5.7 / 10万（95%置信区间，5.5-6.0）。白人女性的校正率为10万分之4.7 (95% CI, 4.6-4.8)，而未校正率为10万分之3.2 （95% CI, 3.13.2）。在没有校正的情况下，种族间的死亡率差异被低估了44%。85岁以上的黑人妇女的校正率最高：每10万人中有37.2人死亡。校正率的趋势分析表明，白人妇女的发病率每年下降0.8%，而黑人妇女的年下降率为3.6%
BACKGROUND: The objectives of this study were to determine the age-standardized and age-specific annual US cervical cancer mortality rates after correction for the prevalence of hysterectomy and to evaluate disparities by age and race.METHODS: Estimates for deaths due to cervical cancer stratified by age, state, year, and race were derived from the National Center for Health Statistics county mortality data (2000-2012). Equivalently stratified data on the prevalence of hysterectomy for women 20 years old or older from the Behavioral Risk Factor Surveillance System survey were used to remove women who were not at risk from the denominator. Agespecific and age- standardized mortality rates were computed, and trends in mortality rates were analyzed with Joinpoint regression.RESULTS: Age-standardized rates were higher for both races after correction. For black women, the corrected mortality rate was 10.1 per 100,000 (95% confidence interval [CI], 9.6-10.6), whereas the uncorrected rate was 5.7 per 100,000 (95% CI, 5.5-6.0). The corrected rate for white women was 4.7 per 100,000 (95% CI, 4.6-4.8), whereas the uncorrected rate was 3.2 per 100,000 (95% CI, 3.13.2). Without the correction, the disparity in mortality between races was underestimated by 44%. Black women who were 85 years old or older had the highest corrected rate: 37.2 deaths per 100,000. A trend analysis of corrected rates demonstrated that white women's rates decreased at 0.8% per year, whereas the annual decrease for black women was 3.6% (P