E-poster Presentation 2014 World Cancer Congress

Racial disparities in cervical cancer (CC) survival in Brazil (#786)

Angélica Nogueira Rodrigues 1 , Andreia Cristina de Melo 2 , Flávia Vieira G. Alves 2 , Laísa Gabrielle Silva 3 , Cristiane Alves Gonçalves 3 , Mariana do Nascimento Vilaça 3 , Juliana Chaves Fabrini 3 , Luiz Cláudio Santos Thuler 4
  1. Oncology, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brazil
  2. Ginecology Oncology, Instituto Nacional do Câncer, Rio de Janeiro, RJ, Brazil
  3. Medical School, Universidade de Itaúna, Itaúna, MG, Brazil
  4. Clinical Research, Instituto Nacional do Câncer, Rio de Janeiro, RJ, Brazil

Background and Aim: The purpose of this study is to examine differences in survival for black and non-black women diagnosed with (CC) and treated in a developing country.

Methods: Medical records of CC patients treated from 2006-2009 at the Brazilian National Cancer Institute were reviewed. Differences in survival were evaluated between black and non-black women. Chi-square tests and Odds Ratios (OR) with 95% confidence intervals (95% CI) were calculated. Survival was examined using the Kaplan–Meier method. Single and multivariate Cox proportional hazards modeling was used to estimate Hazard Ratios (HR) with 95% CI.

Results: The study sample included 1,482 women, including 188 (12.7%) who were black, 1,209 (81.6%) who were non-black and 85 (5.7%) not specified. There were no significant differences between black and non-black patients regarding age (p=0.26), number of comorbidities (p=0.20), performance status (p=0.149) or stage at diagnosis (p=0.15). Hemoglobin level at diagnosis lower than 12g/dl  was more frequent in black women (56.5% vs 45.6% p=0.008), they less frequently received cancer-directed surgery (18.1% vs 28.3%, p=0.005) and lymphadenectomy (10.6% vs 18.5%, p=0.027).  There were no differences in the amount of chemotherapy or radiotherapy received by black and non-black women. Overall, black women had a hazard ratio (HR) of 1.5 (95% confidence interval=1.2-1.8) of CC mortality compared with non-blacks. After adjusting for hemoglobin levels, there was no significant difference in CC specific mortality.

Conclusions: In this cohort, black women presented worse survival compared to non-black counterparts, but there was no difference after adjusting for hemoglobin level, which is lower in black CC patients.