Trends in cervical cancer incidence among young black and white women in metropolitan Detroit.

Abstract

Although the overall incidence of invasive cervical cancer in the United States has declined over the past several decades, recent studies suggest that rates for both invasive and in situ cervical cancer are rising among younger women. Trends in cervical cancer incidence among females between the ages of 15 and 39 years were evaluated using data from the Metropolitan Detroit Cancer Surveillance System, a population-based registry and founding participant in the SEER Program of the National Cancer Institute. Age-adjusted and age-specific rates for all black and white women in this age group were evaluated as well as rates for married and single women for the period 1973-1991. Incidence trends vary by race and marital status. A nonlinear increasing trend was evident (P < 0.01), for in situ cervical cancer among white women, with rates for single white women exhibiting the largest increase. Rates among black women for in situ cervical cancer exhibited a nonlinear decreasing trend (P < 0.01), with rates for married black women declining by 75%. Among single white women, invasive cervical cancer exhibited an increasing linear trend (P < 0.01), although the number of cases was small. Differences in trends among black and white women may reflect a combination of greater exposure to risk factors associated with cervical carcinoma as well as differential access to diagnostic and treatment services. Appropriate groups should be targeted for educational, screening, and follow-up services.