ArticleJournal of the National Cancer Institute. Monographs2023
Adapting a model of cervical carcinogenesis to self-identified Black women to evaluate racial disparities in the United States.
Article in Journal of the National Cancer Institute. Monographs, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Breast, Cervical, and Colorectal Cancer Screening Rates in Women Aged 45 to 64 Years.JAMA network open · 2026Article
- Using simulation modeling to guide policy to reduce disparities and achieve equity in cancer outcomes: state of the science and a road map for the future.Journal of the National Cancer Institute. Monographs · 2023Article
- Data gaps and opportunities for modeling cancer health equity.Journal of the National Cancer Institute. Monographs · 2023Article
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6 authors.
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Abstract
backgroundSelf-identified Black women in the United States have higher cervical cancer incidence and mortality than the general population, but these differences have not been clearly attributed across described cancer care inequities.
methodsA previously established microsimulation model of cervical cancer was adapted to reflect demographic, screening, and survival data for Black US women and compared with a model reflecting data for all US women. Each model input with stratified data (all-cause mortality, hysterectomy rates, screening frequency, screening modality, follow-up, and cancer survival) was sequentially replaced with Black-race specific data to arrive at a fully specified model reflecting Black women. At each step, we estimated the relative contribution of inputs to observed disparities.
resultsEstimated (hysterectomy-adjusted) cervical cancer incidence was 8.6 per 100 000 in the all-race model vs 10.8 per 100 000 in the Black-race model (relative risk [RR] = 1.24, range = 1.23-1.27). Estimated all-race cervical cancer mortality was 2.9 per 100 000 vs 5.5 per 100 000 in the Black-race model (RR = 1.92, range = 1.85-2.00). We found the largest contributors of incidence disparities were follow-up from positive screening results (47.3% of the total disparity) and screening frequency (32.7%). For mortality disparities, the largest contributor was cancer survival differences (70.1%) followed by screening follow-up (12.7%).
conclusionTo reduce disparities in cervical cancer incidence and mortality, it is important to understand and address differences in care access and quality across the continuum of care. Focusing on the practices and policies that drive differences in treatment and follow-up from cervical abnormalities may have the highest impact.
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