Sarah C. Markt|Tianyu Tang|Angel M. Cronin|Ingrid T. Katz|Brooke E. Howitt|Neil S. Horowitz|Larissa J. Lee|Alexi A. Wright
Insurance status and cancer treatment mediate the association between race/ethnicity and cervical cancer survival
Harvard University|Harvard University|Dana-Farber Cancer Institute|Harvard University|Center for Global Health|Massachusetts General Hospital|Brigham and Women's Hospital|Harvard University|Brigham and Women's Hospital|Harvard University|Dana-Farber Cancer Institute|Brigham and Women's Hospital|Dana-Farber Cancer Institute|Brigham and Women's Hospital|Harvard University|Harvard University|Dana-Farber Cancer Institute|Brigham and Women's Hospital
cervical cancer outcomes remain poor among disadvantaged populations including ethnic minorities lowincome underinsured women aim study evaluate mechanisms underlie observed association raceethnicity cervical cancer survival identified 13698 women ages 21 64 years diagnosed stages iiii primary cervical cancer 20072013 surveillance epidemiology end results seer multivariable cox proportional hazards regression models evaluated associations raceethnicity nonhispanic white nonhispanic black hispanic cervical cancerspecific mortality conducted mediation analysis calculate mediation proportion 95 confidence interval nonhispanic black women increased risk cervical cancerspecific mortality hr 123 95 ci 108139 hispanic women decreased risk dying disease hr 082 95 ci 072093 compared nonhispanic white estimated proportion excess cervical cancer mortality nonhispanic black women relative nonhispanic white women mediated insurance 186 treatment 472 furthermore nonhispanic black women likely receive radiation less likely receive surgery earlystage disease populationbased study found excess cervical cancerspecific mortality nonhispanic black women mediated factors insurance status treatment findings suggest enhancing existing insurance coverage ensuring equal adequate treatment women may key strategy improving cervical cancer outcomes