Racial and urban/rural differences in cervical carcinoma in Georgia Medicaid recipients

The authors conducted a study of racial and geographic differences in the occurrence of cervical carcinoma in a population of uniformly low economic status: Georgia Medicaid recipients.

Medicaid reimbursement claims data for 1992 were used to calculate counts, rates, and black-to-white risk ratios for newly and previously diagnosed cases of cervical carcinoma in metropolitan Atlanta and in the remainder of the state.

Among 615,787 female Georgia Medicaid recipients in 1992, 2050 women (333 per 100,000) had a diagnosis of carcinoma of the cervix. Of 111,208 women who had received Medicaid assistance continuously from 1988 to 1992 (5-year eligibles), a new claim for cervical carcinoma was submitted for 110 (99 per 100,000). In both analyses, rates were higher in metropolitan Atlanta than in the remainder of the state. Black women had significantly higher claims rates than white women only in metropolitan Atlanta; risk ratios were 3.7 (95% confidence interval [CI], 1.3-10.8) for new claims among 5-year eligibles, and 3.5 (95% CI, 3.0-4.1) for prevalence. There was no racial disparity in cervical carcinoma rates in rural areas.

The current study data suggest a high risk of cervical carcinoma among metropolitan Atlanta Medicaid recipients, particularly blacks. Data from rural Georgia (but not Atlanta) support the hypothesis that racial differences in cervical carcinoma rates would largely disappear in a population of uniform economic status.