BACKGROUND: Invasive cervical cancer (ICC) rates remain elevated in the Appalachian region of the United States. We investigated patterns of invasive cervical cancer incidence rates in three Appalachian states (Kentucky, West Virginia, Pennsylvania) to uncover specific high-risk subgroups within this large and heterogeneous region. METHODS: The analysis was conducted for the three states combined and individually. Invasive cervical cancer rates were characterized by individual and county-level sociodemographic variables, including age, race, poverty, education, Appalachian status, and rural/urban status. Bivariate analyses and multivariable Poisson regression models were conducted to address the relative contributions of each variable to the risk of invasive cervical cancer. RESULTS: The three states differed in the contribution of each factor to the risk of invasive cervical cancer. The overall invasive cervical cancer incidence rates for Kentucky, West Virginia, and Pennsylvania were 13.4, 13.9, and 10.2 per 100,000/yr, respectively. After controlling for other demographic variables, the effect of Appalachian status on invasive cervical cancer was weaker, while rural status, education, and race were stronger, significant predictors. CONCLUSIONS: This study illustrates the heterogeneity of population demographics and invasive cervical cancer risk, and the need to identify subregions and subgroups within Appalachia at highest risk for this disease.
BACKGROUND:Invasive cervical cancer (ICC) rates remain elevated in the Appalachian region of the United States. We investigated patterns of invasive cervical cancer incidence rates in three Appalachian states (Kentucky, West Virginia, Pennsylvania) to uncover specific high-risk subgroups within this large and heterogeneous region. METHODS: The analysis was conducted for the three states combined and individually. Invasive cervical cancer rates were characterized by individual and county-level sociodemographic variables, including age, race, poverty, education, Appalachian status, and rural/urban status. Bivariate analyses and multivariable Poisson regression models were conducted to address the relative contributions of each variable to the risk of invasive cervical cancer. RESULTS: The three states differed in the contribution of each factor to the risk of invasive cervical cancer. The overall invasive cervical cancer incidence rates for Kentucky, West Virginia, and Pennsylvania were 13.4, 13.9, and 10.2 per 100,000/yr, respectively. After controlling for other demographic variables, the effect of Appalachian status on invasive cervical cancer was weaker, while rural status, education, and race were stronger, significant predictors. CONCLUSIONS: This study illustrates the heterogeneity of population demographics and invasive cervical cancer risk, and the need to identify subregions and subgroups within Appalachia at highest risk for this disease.
Authors: Nancy T Artinian; Richard B Warnecke; Kimberly M Kelly; Janet Weiner; Nicole Lurie; John M Flack; Josiemer Mattei; Karl Eschbach; Judith A Long; Alice Furumoto-Dawson; Janet R Hankin; Cecilia DeGraffinreid Journal: Ethn Dis Date: 2007 Impact factor: 1.847
Authors: Electra D Paskett; James L Fisher; Eugene J Lengerich; Nancy E Schoenberg; Stephenie K Kennedy; Mary Ellen Conn; Karen A Roberto; Sharon K Dwyer; Darla Fickle; Mark Dignan Journal: Oncologist Date: 2011
Authors: Swann Arp Adams; Seul Ki Choi; Leepao Khang; Dayna A Campbell; Daniela B Friedman; Jan M Eberth; Russell E Glasgow; Reginald Tucker-Seeley; Sudha Xirasagar; Mei Po Yip; Vicki M Young; James R Hébert Journal: J Community Health Date: 2015-08
Authors: Mira L Katz; Paul L Reiter; Brenda C Kluhsman; Stephenie Kennedy; Sharon Dwyer; Nancy Schoenberg; Andy Johnson; Gretchen Ely; Karen A Roberto; Eugene J Lengerich; Pamela Brown; Electra D Paskett; Mark Dignan Journal: Vaccine Date: 2009-04-07 Impact factor: 3.641