What factors explain observed racial/ethnic differences in cervical cancer survival?
• In this context, “explain” means that observed racial differences in survival disappear when adjusting for a factor. Factors include: SES, urban/rural residence (access), treatment received (access), comorbid conditions (competing risks of death), age and stage at diagnosis (primary predictors of survival), and others (including partner violence against women). • Texas studies • Dr. Coker conducted an NCI-funded study in a large, ethnically diverse population of nearly 7,000 cervical cancer cases with confounder data on neighborhood (not individual) SES and urbanicity. The investigators used Census data; geocoding of addresses; and random matching of zip code, race, age, and sex to estimate neighborhood urbanicity and SES. • Findings included that, compared to white women with cervical cancer, non-Hispanic black and Hispanic women with cervical cancer were more likely to have the lowest SES, live in an urban environment, and have their cancer diagnosed at a later stage. • In addition
