Burden of invasive cervical cancer in North Carolina

ObjectiveCervical cancer causes over 4000 deaths yearly in the United States, although highly preventable through vaccination, screening, and early treatment. We aimed to determine demographic correlates for cervical cancer in North Carolina to identify target populations for interventions and to create a framework for state-level analyses.MethodData on all reported invasive cervical cancer cases from 1998 to 2007 were obtained from the North Carolina Central Cancer Registry. Age-adjusted incidence and mortality rates were estimated using population data from the National Center for Health Statistics.ResultsCervical cancer incidence and mortality rates varied greatly by county and were inversely associated with county prosperity. Hispanic women had the highest incidence rate, black women the highest mortality rate, although white women accounted for most cases. Incidence rates remained fairly steady above age 35 and mortality rates steadily increased with age. A later stage at diagnosis was more common for older women and for women without private insurance.ConclusionRegistry-based assessment illustrates the economic, racial, and age disparities associated with cervical cancer. This localized focus on demographic correlates is an important step toward eliminating this preventable disease and offers a template for cervical cancer prevention programs in other states.

►A registry-based assessment of risk factors for cervical cancer in North Carolina. ► Counties with lower prosperity had higher incidence and mortality rates. ► Hispanics had the highest incidence rate, blacks the highest mortality rate, but whites the highest count. ► Incidence rate held steady with age. Mortality rate and stage at diagnosis increased with age. ► Women without private insurance had a later, more severe stage at diagnosis.