Evaluation of Geographic Disparities in Cervical Cancer Survival Across Maine

Abstract

Introduction. National data exists suggesting the existence of geographic disparities in oncology care within the United States. It is unknown whether geographic disparities present a problem for women with gynecologic malignancies locally in Maine. Methods. Data for each cervical cancer case diagnosed or treated under the MaineHealth system between 2007 and 2011 were acquired from the MaineHealth Network Registry. Average annual incidence and 5-year survival were calculated for each county in Maine and were mapped using geographic information systems (GIS) software. Next, cases were divided into 2 groups: those residing less than or equal to 60 miles from the sole gynecologic oncology practice in Maine and those residing over 60 miles from the practice. 5-year survival rates of each group were compared using chi-square testing. Demographics and risk factors of the two groups were compared with the 2-sample t-test or Fisher’s exact test. Results. The average annual incidence of cervical cancer in each county of Maine between 2007 and 2011 ranged from 0 to 0.91 new cases per 10,000 female persons. The 5-year survival rate within each county ranged from 0% to 100%. Women with cervical cancer residing less than or equal to 60 miles from the Maine-based gynecologic oncology practice had a 5-year survival rate of 63.0%, while those residing farther than 60 miles had a 5-year survival rate of 71.9% (p=0.12). Conclusions. No significant geographic disparities in survival outcomes were found for women diagnosed with cervical cancer in Maine between 2007 and 2011.