Geographic trends in cervical cancer incidence and mortality in Kentucky, 1995-2000.

BACKGROUND: Kentucky's elevated cervical cancer incidence and mortality rates are well documented. However, in Kentucky, as in the United States as a whole, cervical cancer incidence and mortality have been decreasing. METHODS: To determine if the incidence and mortality declines in Kentucky are similar in different geographic regions of the state, incidence and mortality data for the six-year period 1995-2000 were analyzed by five geographic subdivisions. RESULTS: Overall, both incidence and mortality rates declined during the six-year period; however, there were variations in the decline by geographic subdivisions. In 1995-2000, the greatest percentage decrease (43%) in incidence rates among the geographic subdivisions occurred in Fayette/Jefferson counties while their mortality rates increased (12%). Conversely, the Appalachian region of the state had a lower percentage decrease (11%) in incidence with a concurrent percentage decrease in mortality (45%). CONCLUSIONS: Intensified screening efforts may have resulted in increased detection of early stage cervical disease; which provided a subsequent reduction in mortality for the Appalachian region of the state, while Fayette/Jefferson County has a mortality rate that slopes upward necessitating additional investigation.