Cervical cancer is the second leading cause of cancer deaths among women in developing nations, ranking number 10 among women in economically developed populations. Researchers from the Loma Linda University School of Public Health (LLUSPH) analyzed more than 13,000 cases of cervical cancers in California, using the California Cancer Registry (CCR), and their findings were published in the April 2015 issue of Annals of Epidemiology.

[Photo: Dr. John Morgan]

The CCR encompasses the statewide population of nearly 38 million and includes wide sociodemographic diversity for characteristics such as race and ethnicity, socioeconomic status (SES), and marital status. The large size and rich diversity of the California population, combined with the complex SES index developed by the CCR, provide a unique opportunity to assess independent roles of age, race and ethnicity, SES, and marital status as predictors of delayed- versus early-stage cervical cancer.

“Every death from cervical cancer in the U.S. today represents failure of Pap screening that should have detected this as treatable early-stage cancer or as a premalignant condition,” said Dr. John Morgan, professor at LLUSPH. “This research reveals that more lives would be saved by targeted screening of women residing in low socioeconomic status neighborhoods, rather than targeting based on race/ethnicity.” Dr. Morgan is also the epidemiologist for regions 4, 5, 7, and 10 of the NCI SEER Cancer Registry of Greater California.

The findings showed that 58 percent of cervical cancers were among women younger than 50 years, compared with 46 percent of delayed-stage cases. Odds of delayed- versus early-stage cervical cancer were highest among unmarried compared with married women

These findings also support evidence that older age, low SES, and unmarried status predict delayed-stage cervical cancer diagnosis in each of the four major race and ethnic groups. Larger percentages of delayed-stage cervical cancers were found particularly amongst Hispanic and non-Hispanic Black women.