The highest percentage of racial and ethnic disparities in the delivery of locally advanced guideline-based care for cervical cancer is in high-volume hospitals, a recent study found. This retrospective cohort study included 16,195 women diagnosed between 2004 and 2012 with locally advanced squamous or adenocarcinoma of the cervix and undergoing definitive primary radiation therapy. Primary outcome was the race-ethnicity-based rates of adherence to the National Comprehensive Cancer Network guideline-based care. Researchers found:
- Rate of guideline-based care was 58.4% for non-Hispanic white, 53% for non-Hispanic black, and 51.5% for Hispanic women.
- During the study period, the rate of guideline-based care increased from 49.5% to 59.1%.
- Patients receiving guideline-based care had a lower risk of mortality (aHR, 0.65).
- Adherence increase to guideline-based care in high-volume hospitals was 48-63% for non-Hispanic white, 47-53% for non-Hispanic black, and 41-54% for Hispanic women, when compared to low-volume hospitals.
Uppal S, Chapman C, Spencer RJ, et al. Association of hospital volume with racial and ethnic disparities in locally advanced cervical cancer treatment. [Published online ahead of print January 9, 2017]. Obstet Gynecol. doi:10.1097/AOG.0000000000001819.
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Maternal Factors in Cervical Cancer Prevention, Womens Health Issues; ePub 2019 Jan 10; Charlton, et al
Combined Gynecologic Ca & Pelvic Floor Dysfunction Surgery, Female Pelvic Med Reconstr Surg; ePub 2018 Oct 22; McConnell, et al