Socioeconomic status and cervical cancer survival among older women: Findings from the SEER-Medicare linked data cohorts

Ann L. Coker, Xianglin L. Du, Shenying Fang, Katherine S. Eggleston

Research output: Contribution to journalArticlepeer-review

57 Scopus citations

Abstract

Objectives: Tumor stage, age, and cell type are well-characterized predictors for cervical cancer survival; socioeconomic factors may also play an important role. The purpose of this study is to estimate cervical cancer survival by socioeconomic indicators and race/ethnicity among elderly women diagnosed with cervical cancer. Methods: We studied 1251 women with cervical cancer aged 65 or older, identified between 1992 and 1999 from the Surveillance, Epidemiology, and End Results [SEER]-Medicare linked data. All women had similar access to care through Medicare fee-for-services insurance. A composite measure of socioeconomic status was created using census tract level data for poverty, education, and income. Cox proportional hazard modeling was used for all-cause and cervical cancer-specific survival analysis. Results: Increased age (P < 0.0001) and advanced tumor stage (<0.0001) were associated with poorer all-cause and cervical cancer-specific survival. After adjustment for age, stage, and treatment, increased co-morbidity scores and having non-squamous cervical cancer were associated with poorer all-cause survival (P < 0.001). After adjusting for confounders, women receiving hysterectomy vs. no surgery or any treatment had significantly better all-cause and cervical cancer-specific survival. Socioeconomic factors were not associated with either all-cause (P for trend = 0.79) or cervical cancer-specific (P for trend = 0.81) survival. No racial/ethnic differences in all-cause or cervical cancer-specific survival were observed after adjusting for socioeconomic factors. Conclusion: Among women with similar access to care, neither minority race/ethnicity nor poorer socioeconomic status were associated with poorer survival in this large sample of older women diagnosed with invasive cervical cancer. Presence of co-morbid conditions and treatment were important predictors of cervical cancer survival.

Original languageEnglish
Pages (from-to)278-284
Number of pages7
JournalGynecologic Oncology
Volume102
Issue number2
DOIs
StatePublished - Aug 2006

Keywords

  • Cervical neoplasia
  • Co-morbid conditions
  • Elderly
  • Medicare
  • Race
  • Socioeconomic status
  • Survival
  • Treatment

ASJC Scopus subject areas

  • Oncology
  • Obstetrics and Gynecology

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