Abstract B112: Disparities in cervical cancer survival among Hispanic subpopulations living in the United States

Abstract

Abstract Purpose: The Hispanic population bears a high burden of cervical cancer; however, disaggregated data, which is vital in equitable resource allocation, lacks in this group. Our study evaluated disparities in cervical cancer survival among Hispanic subpopulations receiving guideline-concordant care and identified factors affecting survival. Methods: Data from the National Cancer Database was used to identify patients with cervical cancer from 2004-2019. The Hispanic cohort was analyzed in its entirety, and by region of origin. Nine quality metrics were established to assess guideline-concordant care for eligible patients across various cancer stages. Demographic data, treatment modalities, and survival were described. Demographic and clinical variables were stratified by Hispanic subpopulation and compared using chi-squared tests. Kaplan-Meier curves were employed to examine cervical cancer survival among the Hispanic subpopulation for each quality metric. Marginal Poisson log-linear models were utilized to evaluate the association Hispanic subpopulation and the receipt of eligible quality metrics, and obtain adjusted relative risks (aRR), while controlling for potential confounders. Results: A total of 77,567 patients were included, 4363 (5.6%) of which identified as Hispanic. Compared to non-Hispanic White (NHW) and non-Hispanic Black (NHB) populations, larger proportion of the Hispanic population was uninsured (19.16%, p < 0.001) and more likely to live in neighborhoods with lowest rates of high school diploma attainment (61.43%, p <0.001). Significant differences in neighborhood income, education level, insurance status, and stage at presentation among Hispanic subpopulations were identified (p<0.001). Survival among patients with stage IA2-IIA2 patients undergoing radical hysterectomy was lowest among NHB and Cuban patients when compared to NHW and other Hispanic patients (p<0.001). Survival among stage IB2-IVA patients undergoing primary radiation and concurrent chemotherapy was also lowest among Cuban, NHW and NHB patients when compared to other populations, and highest among Mexican populations (p<0.001). Among patients with stage IVB disease receiving chemotherapy, Dominican populations had the highest survival rates p<0.001). Compared to Mexican patients, Cuban patients were 1.18 times as likely to receive timely initiation of treatment in early stage (RR 1.18, 95% CI 1.03-1.34, p=0.01). Patients of South or Central American origin (RR 1.18, 95%CI 1.09-1.28, p< 0.001), Cuban (RR 12.5, 95%CI 1.1-1.43, p<0.001), and Dominican (RR1.19, OR 1.01-1.4, p=0.03) were more likely to undergo timely initiation of treatment in locally advanced disease when compared to Mexican patients. Conclusion: Significant differences in survival outcomes for patients with cervical cancer were identified among our cohort, as well as within the Hispanic population. Variation in initial of treatment, treatment type received, and social factors may contribute to these disparities. Citation Format: Andreea Dinicu, Shayan Dioun, Yongzhe Wang, Yongmei Huang, Jason Wright, Ana Tergas. Disparities in cervical cancer survival among Hispanic subpopulations living in the United States [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr B112.