NYC Has Some of the Nation’s Largest Disparities in Cervical Cancer Rates
The rate of cervical cancer among women living in New York City neighborhoods with the lowest socioeconomic indices—populated predominantly by Black and Hispanic residents—is nearly two times higher than the rate among New Yorkers who live in the city’s neighborhoods with the highest socioeconomic indices, which are largely white.
The magnitude of the disparity exceeds those previously reported for Black race and Hispanic ethnicity compared with whites and that associated with rural residents compared with urban residents.
The study, the first to look at the role of socioeconomic status in cervical cancer disparities in New York City, was published in JAMA Oncology on Nov. 24.
The neighborhood disparities in cervical cancer are primarily driven by very high rates in New York neighborhoods with the lowest socioeconomic indices.
“We found that a neighborhood at the 10th percentile of the socioeconomic distribution is predicted to have a cervical cancer incidence of 11.2 cases a year per 100,000 women, which is significantly higher than the national average of 7.0 cases a year per 100,000 women,” says the study’s lead author, Alexander Melamed, MD, MPH, assistant professor of obstetrics & gynecology at Columbia University Vagelos College of Physicians and Surgeons.
Cervical cancer rates in New York neighborhoods at the 90th percentile of the socioeconomic scale had cervical cancer rates of 6.5 cases a year per 100,000 women, close to the national average.
The existence of the disparity among people living in such proximity highlights the need to implement neighborhood-level interventions to increase access to, and use of, preventive services, the paper’s authors write.
“Cervical cancer is highly preventable with vaccination and regular screening,” Melamed says. “The HPV vaccine reduces the rate by 90% when administered by age 12 or 13, and regular screening can find pre-cancers before they can turn into invasive tumors.”
For women in Northern Manhattan, the dysplasia clinic at Columbia University Irving Medical Center plays an important role in reducing the incidence of cervical cancer. The clinic is a referral center for women with precancerous lesions or high-risk HPV infections and provides treatment to uninsured women, who have greater risk of cervical cancer.
The dysplasia clinic at Columbia University Irving Medical Center is directed by Allison Gockley, MD, assistant professor of obstetrics & gynecology at Columbia University Vagelos College of Physicians and Surgeons.
All authors: Stephanie Cham (Brigham and Women’s Hospital and Dana Farber Cancer Institute), Alicia Li (Columbia), J. Alejandro Rauh-Hain (University of Texas MD Anderson Cancer Center), Ana I. Tergas (Columbia), Dawn L. Hershman (Columbia), Jason D. Wright (Columbia), and Alexander Melamed (Columbia).
The study was supported in part by a Conquer Cancer-Stephen A. Cannistra, MD, Career Development Award in Gynecologic Cancers from the Conquer Cancer Foundation and the NIH (grant KL2TR001874).
For work unrelated to the paper: Ana Tergas has received personal fees from Immunomics for participation in an advisory board and from Auro Vaccines for consulting services for vaccine development. Jason Wright has received personal fees from Clovis Oncology and UpToDate and grants from Merck.