No racial disparities in stage at diagnosis – is Nevada doing better for cervical cancer?

Background: As a result of cervical cancer (CC) screening and immunization; CC is one of the most preventable cancers. Nonetheless, disparities in access or underuse of CC screening often result in advanced stage at diagnosis and unfavorable prognosis in some minority groups. This study's aim is to assess if racial differences exist in CC stage at diagnosis among Nevadan females.

Methods: The study population consisted of 1,434 women diagnosed with CC between 1995 and 2008, identified through the Nevada Central Cancer Registry. Multiple logistic regression modeling was used to calculate the odds of being diagnosed at an advanced stage in relation to localized stage.

Results: Adjusted for age, SES, marital status, insurance, histology, and diagnosis period; CC stage at diagnosis for Blacks [OR=0.8, 95% CI: 0.53-1.38], Hispanics [OR=0.9, 95%CI: 0.63-1.21], and American Indian women [OR=0.8, 95% CI: 0.25-2.72] were not significantly different compared to White women. Women who were uninsured [OR =1.9, 95% CI: 1.30-2.80] or insured under Medicaid [OR=2.8, 95% CI: 1.80-4.59] were more likely to be diagnosed at late stage than privately insured women.

Conclusions: Findings of this study indicate an absence of disparities in CC stage at diagnosis between minority groups and Whites, which could represent a progressive step in Public Health. However, given the unique public health context in the Silver State, these results suggest unfavorable patterns of early detection among Whites. Lower CC screening occurs among Nevadan Whites than national average. Consequently, evidence-based interventions to increase prevention levels among White Nevadan residents may be warranted.