Cervical Cancer Death Rates Among US- and Foreign-Born Women: US, 2005-2014

• Authors: Benjamin D. Hallowell, Centers for Disease Control and Prevention; Meheret Endeshaw, Centers for Disease Control and Prevention; Matthew McKenna, Emory University; Virginia Senkomago, Centers for Disease Control and Prevention; Hilda Razzaghi, Centers for Disease Control and Prevention; Mona Saraiya, Emory University
• Journal Title: AMERICAN JOURNAL OF PREVENTIVE MEDICINE
• Volume: Volume 56, Number 6
• Publisher: ELSEVIER SCIENCE INC | 2019-06-01, Pages 869-874
• Type of Work: Article | Post-print: After Peer Review
• Publisher DOI: http://doi.org/10.1016/j.amepre.2019.01.007
• Subjects: Health Sciences, Public Health; Health Sciences, Oncology; Health Sciences, Obstetrics and Gynecology
• Keywords: Science & Technology; Life Sciences & Biomedicine; Public, Environmental & Occupational Health; Medicine, General & Internal; General & Internal Medicine; UNITED-STATES; MORTALITY; SERVICES; TRENDS

Abstract

Introduction: Historically, foreign-born women in the U.S. are less likely to be screened and are more likely to die from cervical cancer when compared with their U.S.-born counterparts. In order to inform prevention efforts and reduce this health disparity, mortality data were obtained from the National Center for Health Statistics to describe cervical cancer mortality among U.S.- and foreign-born women. Methods: Annual population estimates were obtained from the U.S. Census Bureau's American Community Survey from 2005 to 2014. From 2017 to 2018, age-adjusted mortality rates and rate ratios were calculated by nativity status, race/ethnicity, age, geographic region, and country of birth. Results: From 2005 to 2014, a total of 5,924 deaths from cervical cancer were recorded among the foreign-born population, compared with 33,893 deaths among U.S.-born women. Overall, foreign-born women had a lower cervical cancer mortality rate when compared with the U.S.-born women (rate ratio=0.95, 95% CI=0.92, 0.97). However, older foreign-born women had significantly higher mortality rates compared with U.S.-born women: aged 65–79 years (rate ratio=1.15, 95% CI=1.09, 1.22)and ≥80 years (rate ratio=1.43, 95% CI=1.32, 1.55). Women born in Mexico had significantly elevated rates of cervical cancer mortality (rate ratio=1.35, 95% CI=1.27, 1.42)when compared with U.S.-born women. Conclusions: Efforts that work to increase cervical cancer screening access and guideline compliance might further reduce the cervical cancer deaths in the U.S., and the excess burden observed among older foreign-born women.