Cervical Cancer 2010-2019: An Upper Midwest Catchment of 40,000 Square Miles

Area of Science:

• Oncology
• Public Health
• Epidemiology

Background:

• American Indian (AI) women experience disproportionately higher incidence and mortality rates for cervical cancer compared to non-Hispanic White (NHW) women in the United States.
• Understanding the clinical progression of cervical cancer in AI women is crucial for improving prevention and treatment strategies.

Purpose of the Study:

• To analyze the clinical events within the cervical cancer prevention continuum for American Indian and White women diagnosed with cervical cancer in the US frontier.
• To identify disparities and challenges in cervical cancer screening, diagnosis, and treatment between these populations.

Main Methods:

• A retrospective analysis of cervical cancer patients (2010-2019) from a large US frontier cancer registry.
• Inclusion of both American Indian and White populations within the nearly 40,000 square-mile catchment area.
• Descriptive and inferential statistics, including modeling, to detail the prevention continuum.

Main Results:

• Among 126 cervical cancer patients, 20% were AI and 78% were White.
• A significant majority (60%) lacked screening within 5 years prior to diagnosis, with an average of 9.2 years since last screening.
• Ninety-one percent presented with symptoms, often multiple, and colposcopy as a diagnostic step was associated with significant delays in diagnosis.
• Survival rates were 63% overall, with 42% surviving at least 3 years; younger age and earlier stage at diagnosis predicted better survival.

Conclusions:

• The study reveals critical gaps in the cervical cancer prevention continuum for AI women, including delayed screening and diagnosis.
• Findings question the utility of colposcopy as an initial diagnostic step for symptomatic women, suggesting potential delays.
• Targeted interventions are needed to improve screening adherence and timely diagnosis to reduce cervical cancer burden in AI women.