TRENDS IN CERVICAL-CANCER INCIDENCE AMONG YOUNG BLACK-AND-WHITE WOMENIN METROPOLITAN DETROIT

Background. Although the overall incidence of invasive cervical cancer in the United States has declined over the past several decades, rece nt studies suggest that rates for both invasive and in situ cervical c ancer are rising among younger women. Methods. Trends in cervical canc er incidence among females between the ages of 15 and 39 years were ev aluated using data from the Metropolitan Detroit Cancer Surveillance S ystem, a population-based registry and founding participant in the SEE R Program of the National Cancer Institute. Age-adjusted and age-speci fic rates for all black and white women in this age group were evaluat ed as well as rates for married and single women for the period 1973-1 991. Results. Incidence trends vary by race and marital status. A nonl inear increasing trend was evident (P < 0.01), for in situ cervical ca ncer among white women, with rates for single white women exhibiting t he largest increase. Rates among black women for in situ cervical canc er exhibited a nonlinear decreasing trend (P < 0.01), with rates for m arried black women declining by 75%. Among single white women, invasiv e cervical cancer exhibited an increasing linear trend (P < 0.01), alt hough the number of cases was small. Conclusions. Differences in trend s among black and white women may reflect a combination of greater exp osure to risk factors associated with cervical carcinoma as well as di fferential access to diagnostic and treatment services. Appropriate gr oups should be targeted for educational, screening, and follow-up serv ices.