Ethnic differences in patterns of care of stage 1A(1) and stage 1A(2) cervical cancer: A SEER database study

Objective. The aim of this study was to evaluate patterns of care for women with Stage 1A(1) and 1A(2) cervical cancer utilizing the SEER database. Methods. Review of SEER data from 11 registries from 1990 to 1995 was perfo rmed. Data from 2358 women were reviewed and stratified by substage, ethnic ity, type of therapy, and age. Results. Three remarkable differences among subgroups were identified. (1) Among women greater than or equal to 35 years of age, whites were more like ly to have Stage 1A(1) cancer than blacks or Hispanics; OR (95% CI)= 1.56 ( 1.05, 2.31) and 1.41 (1.04, 1.91.), respectively. (2) Patients greater than or equal to 35 years of age were more likely to undergo hysterectomy than younger patients both for 1A(1) and 1A(2) stages; OR (95% CI) = 2.31 (1.68, 3.19) and 2.78 (2.21, 3.50), respectively, with Mantel-Haenszel test of in dependence chi(2) = 102.9943; P value < 0.001. (3) Black and Hispanic women greater than or equal to 35 years of age with BA, disease were less likely to have a hysterectomy than whites. Only 15% of Hispanic patients and 9% o f blacks over the age of 35 and with Stage 1A(2) were treated via hysterect omy, compared to 76% of white women. Differences in hysterectomies for <35 years of age, 1A(1) patients approached but did not reach statistical signi ficance: blacks 36% versus Hispanic/whites 59%, P value = 0.07. Conclusions. Older white women were more likely to have cervical carcinoma diagnosed at an earlier stage (1A(1)) than age-matched blacks or Hispanics. Older patients, across all ethnic groups analyzed, were also more likely t o be treated for both Stage 1A(1) and 1A(2) disease via hysterectomy than y ounger patients. Ethnic differences in the management of women with Stage 1 A(2) cervical cancer do exist: older minority women are less likely to have a hysterectomy and more likely to be treated via fertility-sparing, less d efinitive procedures than whites. (C) 1999 Academic Press.