Sociodemographic inequities in overall survival among younger and older women with cervical cancer.

Abstract

Purpose:  Older Black women and women living in areas of low socioeconomic status (SES) diagnosed with cervical cancer (CC) have worse overall survival (OS). The objective was to investigate associations between OS and race/ethnicity and sociodemographic factors in younger (21-64 years) and older women (≥ 65 years) diagnosed with CC using Surveillance, Epidemiology, and End Results Program data.

Methods:  This retrospective, population-based cohort study included 39,000 women ≥ 21 years diagnosed with CC diagnosed between 2006 and 2020. Age-group stratified Cox proportional hazards models adjusted for age, diagnosis year, and histology examined sociodemographic (rurality, SES, and persistent poverty) differences in OS.

Results:  In the sample, 82.8% were < 65 years. Compared to younger women, older women were more likely to be non-Latinx (NL) Black (16.0 vs 12.9%) and diagnosed with late-stage CC (67.9 vs 47.5%). Adjusted models suggested younger NL Black women had worse OS than their NL White counterparts (HR 1.45 [95% CI 1.37-1.54]), this association was not found among older NL Black women (HR 1.06 [95% CI 0.96-1.16]). Similarly, younger women in lowest SES areas had worse OS compared to women in highest SES areas (HR 1.82 [95% CI 1.69-1.96]), this association was attenuated in older women (HR 1.27 [95% CI 1.15-1.42]). Finally, younger women living in persistent poverty had worse OS compared to those who did not (HR 1.40 [95% CI 1.32-1.48]), this association was not found in older women (HR 1.10 [95% CI 0.99-1.21]).

Conclusion: Sociodemographic disparities were found in CC OS for women < 65 that were attenuated or nonexistent in women ≥ 65 years.