Race, stage of disease, and survival with cervical cancer

Significant disparities in survival with cervical cancer were observed according to social and disease characteristics of 3711 patients from Connecticut from 1984 through 1988. Women with advanced disease were 25 times more likely to die during a 4-year follow-up than those diagnosed with carcinoma in situ. Elevated risk of death was also noted for blacks (OR = 1.73; 95% CI = 1.2-2.5) and for women diagnosed after the age of 52 years (OR = 33.4; 95% CI = 16.5-69.9). Persons living in census tracts with large proportions of high school graduates or with high median incomes experienced decreased risk (OR = 0.66; 95% CI = 0.45-0.98 and OR = 0.65; 95% CI = 0.44-0.95, respectively). Multivariate logistic regression analysis found the effects of stage of disease on vital status to be reduced by approximately 50% when adjusted for other factors, reflecting the sizable effect of a woman's background on those variables. Nonwhite and older women were at significantly greater risk of being diagnosed with invasive disease.