There are disparities in cervical cancer treatment options between African American (Black) and White women in Alabama. The objective of this study was to identify and assess factors contributing to the prevailing inequalities in cervical cancer treatment options between Blacks and Whites, who are living in urban, rural Black Belt (BB), and other rural counties of Alabama. The data of our study population, which was comprised of 2,124 cases of cervical cancer in women 17 years and older, were extracted from the 2004 to 2013 dataset of the Alabama Department of Public Health (ADPH) Cancer Registry. For the analysis of frequency distributions, chi-square, and logistic regression tests SAS software was used. Racial disparities in cervical cancer treatment options for Blacks living within the same counties as Whites still exist. The study analysis showed that younger Blacks living in urban counties with advanced stages of cervical cancer were more likely to receive radiation treatment options but were less likely to undergo surgical treatment options (p-value <.0001). Younger Blacks living in the rural BB and other rural counties were mainly treated with radiation options for the early stages of cervical cancer (p-value 0.001), while older ones received surgery options (p-value <.0001), and combined therapy of surgery and radiation options (p-value 0.05). When adjusted for age, stage of cancer, and county of residence, Blacks had 2.76 (95% CI 0.90-8.86) times the odds ratio of receiving immunotherapy options compared to Whites. Blacks had 0.74 (95% CI 0.58-0.95) times adjusted odds ratio of undergoing less surgery option compared to Whites. Our study findings suggest that cervical cancer treatment options and control interventions targeted towards disadvantaged women, particularly Blacks living in the rural BB and other rural counties have the potential to reduce and/or eradicate this preventable disease.
Keywords: Alabama counties; Blacks; Cervical cancer; Cervical cancer treatment options; SAS software; Whites; disparities.