Cervical cancer geographical burden analyzer: An interactive, open-access tool for understanding geographical disease burden in patients with recurrent or metastatic cervical cancer.

Abstract

5523 Background: Examining geographic distributions of high and low proportions of recurrent or metastatic cervical cancer (r/mCC) can identify regions with high need of intervention and advance our understanding of r/mCC community-specific risk factors. Previous studies of epidemiologic or geographic clusters in late-stage cervical cancer were conducted prior to the availability of modern treatments for r/mCC. Due to the rapidly evolving treatment landscape for r/mCC use of commercial claims is an important way to follow dynamic practice changes. Our study objective was to understand recent geographical disparities among r/mCC patients in the US. Methods: We developed a web-based tool, Cervical Cancer Geographical Disease Burden Analyzer, that allows users to quantify r/mCC disease burden across metropolitan statistical areas (MSA) over multiple years. The inputs to the web-based tool were extracted through a retrospective analysis of the 2015-2020 MarketScan commercial claims database using a previously validated methodology. We then calculated the r/mCC rate as the ratio of r/mCC cases over cervical cancer (CC) cases for each of the >400 MSA considered. The calculated MSA-specific r/mCC rate was visualized in an interactive US map,. The online interactive tool allowed the users to filter the results by year, age group, and minimum number of diagnoses at the MSA level. Results: Our findings showed that there is large variation with respect to r/mCC disease burden across MSA in the US, with a range of 0-45%. The top five MSA with the highest r/mCC rates from 2018-2020 are presented in the table. In particular, r/mCC rates in Sacremento-Roseville-Arden-Arcade (SRAA), CA and Boston-Cambridge-Newton (BCN), MA were on an increasing trajectory (33% in 2018 to 50% in 2020 in SRAA, CA; and from 41% in 2018 to 50% in 2020 in BCN, MA). On the other hand, while disease burden remained high, we observed decreasing r/mCC rates in Grand Rapids, MI (55% in 2018 and 31% in 2020, resulting in an average r/mCC rate of 42%). Finally, in Cape Coral-Fort Myers, FL and Baltimore-Columbia-Towson, MD the r/mCC rates have fluctuated across time but were consistently >30%. Conclusions: Our web-based online interactive tool can help with identifying areas with high need of intervention, and inform how access, prevention and new or emerging therapies may potentially change the distribution of r/mCC disease burden. To better understand underlying drivers of geographic disparities observed, further efforts should be targeted towards identifying local-level factors. [Table: see text]