Abstract 267: GeoSurveillance of invasive cervical cancer incidence by counties in the state of Maryland

Abstract

Abstract Background: Invasive cervical cancer (ICC) is a highly preventable cancer whose rates have dramatically declined over the past few decades. In spite of the progress made, new ICC cases are recorded annually in Maryland and in other parts of the United Sates. We assessed if ICC incidence varied significantly 2005-2012 and across counties within the state of Maryland. Methods: Using a discrete Poisson model we evaluated significant space-time clusters of both high and low ICC incidence rates over a retrospective 10-year period. All analyses were conducted at the county level, using 2-year aggregates of time. We adjusted for age, percent minority, cervical cancer screening rates, median income, obesity as well as smoking rates within each county in our final cluster detection analysis. Results: ICC was 13.1 per 100,000 female population and did vary by county and over the 10-year period assessed. We identified five significant space-time clusters of ICC incidence, three of which were clusters of higher than expected rates. The most likely cluster identified was a cluster of low ICC incidence [aRR=0.08, p-value<0.01] observed for the period 2009-2012 and comprised six high-income suburban counties. The other cluster of low rate [aRR=0.41, p-value<0.01], which was a secondary cluster, was observed for the same time period, 2009-2012 in three high to moderate-income suburban counties. There were two clusters of high ICC incidence, observed for recent time periods. One cluster [aRR=1.74, p-value<0.01], which was made up of a single moderate to low-income urban county was identified for the period 2009-2012. The other cluster of elevated rates [aRR=2.47, p-value<0.01] was identified in a suburban moderate-income county for the period 2011-2012. Additionally, for the period 2005-2008 we identified a historical cluster of elevated incidence [aRR=2.53, p-value<0.01]. Conclusion: Overtime some counties in Maryland have experienced significantly lower rates of disease than expected. However there are more recent clusters of higher than expected rates of disease, which are not explained by the county level variables adjusted for. These clusters of high rates need to be further examined and addressed. Citation Format: Sally Peprah, Frank Curriero, Amber D'Souza. GeoSurveillance of invasive cervical cancer incidence by counties in the state of Maryland [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 267. doi:10.1158/1538-7445.AM2017-267