Disparities in cervical cancer mortality rates as determined by the longitudinal hyperbolastic mixed-effects type II model

PLoS One. 2014 Sep 16;9(9):e107242. doi: 10.1371/journal.pone.0107242. eCollection 2014.

Abstract

Background: The main purpose of this study was to model and analyze the dynamics of cervical cancer mortality rates for African American (Black) and White women residing in 13 states located in the eastern half of the United States of America from 1975 through 2010.

Methods: The cervical cancer mortality rates of the Surveillance, Epidemiology, and End Results (SEER) were used to model and analyze the dynamics of cervical cancer mortality. A longitudinal hyperbolastic mixed-effects type II model was used to model the cervical cancer mortality data and SAS PROC NLMIXED and Mathematica were utilized to perform the computations.

Results: Despite decreasing trends in cervical cancer mortality rates for both races, racial disparities in mortality rates still exist. In all 13 states, Black women had higher mortality rates at all times. The degree of disparities and pace of decline in mortality rates over time differed among these states. Determining the paces of decline over 36 years showed that Tennessee had the most rapid decline in cervical cancer mortality for Black women, and Mississippi had the most rapid decline for White Women. In contrast, slow declines in cervical cancer mortality were noted for Black women in Florida and for White women in Maryland.

Conclusions: In all 13 states, cervical cancer mortality rates for both racial groups have fallen. Disparities in the pace of decline in mortality rates in these states may be due to differences in the rates of screening for cervical cancers. Of note, the gap in cervical cancer mortality rates between Black women and White women is narrowing.

Publication types

  • Historical Article
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Algorithms
  • Appalachian Region / epidemiology
  • Appalachian Region / ethnology
  • Black or African American
  • Female
  • History, 20th Century
  • History, 21st Century
  • Humans
  • Models, Statistical
  • Mortality
  • SEER Program
  • Southeastern United States / epidemiology
  • Southeastern United States / ethnology
  • Texas / epidemiology
  • Texas / ethnology
  • Uterine Cervical Neoplasms / epidemiology*
  • Uterine Cervical Neoplasms / history
  • Uterine Cervical Neoplasms / mortality
  • White People