Assessment of Cervical Cancer Incidence, Histopathology, and Screening Practices Among Hispanic Women in Latin America and Michigan.

Abstract

Cervical cancer is the third most common cancer among women worldwide, with 85% of its global burden occurring in less-developed countries. Although incidence rates of cervical cancer have declined in recent years, high rates persist in Latin America and the Caribbean (LAC) and among Hispanics in the United States (US). With global population growth and aging, the number of cervical cancer cases is expected to increase 46% by 2030. Effective prevention and control efforts will be needed; however, they should be based on accurate estimations of cervical cancer incidence and histopathology, and should consider local screening behaviors.

In LAC, data from 14 population-based cancer registries were used to examine variation in cervical cancer incidence and histopathologic types. In Peru, data obtained from three population-based cancer registries were used to evaluate within-country differences in cervical cancer incidence and histopathologic types. In Michigan, the Special Cancer Behavioral Risk Factor Survey was used to assess cervical cancer screening (Pap test) practices and identify predictors of screening.

Results demonstrated substantial variation in age-standardized cervical cancer incidence rates (ASR) across LAC (ASR: 14.58-43.95 per 100,000). Histopathologic types also varied widely, and patterns of age-specific incidence curves fluctuated considerably across the LAC region. In Peru, heterogeneity was found among registries in the incidence of overall, age-, and histopathology-specific cervical cancer. Results from one registry, Trujillo (1984-2002), showed significant trends toward decreasing overall cervical cancer incidence, but suggested increasing trends in adenocarcinoma incidence among young women (15-29 years). In Michigan, screening behaviors of Hispanics and non-Hispanic whites were similar; however, Hispanics still reported being recently screened (83.0%) at levels below Healthy People 2020 targets (93.0%). Younger age, higher education, having health care coverage, and cervical cancer knowledge were identified as significant predictors of cervical screening among Hispanics in Michigan.

Cervical cancer prevention and control efforts should focus on understanding local cervical cancer incidence and distribution of histopathologic types, together with prevalence and predictors of cervical cancer screening behaviors. With this insight, public health policies could be implemented favoring more effective methods of primary and secondary prevention.