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Variability of cervical cancer rates across 5 Appalachian states, 1998–2003†‡

  1. Claudia Hopenhayn PhD, MPH1,2,§,*,
  2. Jessica B. King MPH3,
  3. Amy Christian MSPH1,
  4. Bin Huang MS1,
  5. W. Jay Christian MPH1

Article first published online: 3 NOV 2008

DOI: 10.1002/cncr.23749

Issue

Cancer

Cancer

Supplement: Assessing the Burden of HPV-Associated Cancers in the United States

Volume 113, Issue Supplement 10, pages 2974–2980, 15 November 2008

Additional Information

How to Cite

Hopenhayn, C., King, J. B., Christian, A., Huang, B. and Christian, W. J. (2008), Variability of cervical cancer rates across 5 Appalachian states, 1998–2003. Cancer, 113: 2974–2980. doi: 10.1002/cncr.23749

Author Information

  1. 1

    Markey Cancer Control Program, Lexington, Kentucky

  2. 2

    College of Public Health, University of Kentucky, Lexington, Kentucky

  3. 3

    National Center for Chronic Disease Prevention and Health Promotion, Coordinating Center for Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia

  1. §

    Fax: (859) 219-0548.

*Markey Cancer Control Program and College of Public Health, University of Kentucky, 2365 Harrodsburg Road, Suite B100, Lexington, KY 40504-3381

  1. †

    This article is a US Government work and, as such, is in the public domain in the United States of America.

  2. ‡

    The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the Centers for Disease Control and Prevention.

Publication History

  1. Issue published online: 3 NOV 2008
  2. Article first published online: 3 NOV 2008
  3. Manuscript Accepted: 18 JUN 2008
  4. Manuscript Revised: 2 JUN 2008
  5. Manuscript Received: 14 APR 2008

Funded by

  • Cooperative Agreement. Grant Number: U50 DP424071-04
  • Centers for Disease Control and Prevention (CDC)

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Keywords:

  • Appalachia;
  • cervical cancer;
  • Papanicolaou testing;
  • rural;
  • women's health

Abstract

BACKGROUND.

Although the rates of invasive cervical cancer (ICC) have decreased substantially in the US since the advent of the Papanicolaou (Pap) test, Appalachian women remain at increased risk compared with the nation as a whole. The ICC incidence rates were compared in 5 Appalachian states with population-based cancer registries to investigate variability within the Appalachian region.

METHODS.

Alabama, Kentucky, Ohio, Pennsylvania, and West Virginia were selected for the analysis on the basis of their having high-quality cancer registry data for 1998 through 2003. Incidence rates were calculated by state and by Appalachia/non-Appalachia, urban/rural, and black/nonblack within each state, following the standard case definition and inclusion criteria used in this supplement. Data from the Behavioral Risk Factor Surveillance System (BRFSS) were used to characterize the prevalence of Pap testing and smoking.

RESULTS.

The ICC incidence rates varied among the 5 states, being highest in West Virginia (10.9 of 100,000) and Kentucky (10.7 of 100,000), and lowest in Ohio (8.2 of 100,000). The Appalachian regions of Kentucky, West Virginia, and Ohio had considerably higher rates than those of Alabama and Pennsylvania. These variations reflected patterns in the rates of poverty, education, smoking, and Pap testing.

CONCLUSIONS.

The variability in ICC risk across subgroups of Appalachia should be considered in the planning of preventive strategies, including reduction in risk factors and promotion of screening and vaccination. Cancer 2008;113(10 suppl):2974–80. Published 2008 by the American Cancer Society.

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