Sociodemographic characteristics of women with invasive cervical cancer in British Columbia, 2004-2013: a descriptive study

CMAJ Open. 2021 Apr 22;9(2):E424-E432. doi: 10.9778/cmajo.20200139. Print 2021 Apr-Jun.

Abstract

Background: Although cancer screening has led to reductions in the incidence of invasive cervical cancer (ICC) across Canada, benefits of prevention efforts are not equitably distributed. This study investigated the sociodemographic characteristics of women with ICC in British Columbia compared with the general female population in the province.

Methods: In this descriptive study, data of individuals 18 years and older diagnosed with ICC between 2004 and 2013 were obtained from the BC Cancer Registry. Self-reported sociodemographic characteristics were derived from standardized health assessment forms (HAFs) completed upon admission in the BC Cancer Registry. Standardized ratios (SRs) were derived by dividing observed and age-adjusted expected counts by ethnicity or race, language, and marital, smoking and urban-rural status. Differences between observed and expected counts were tested using χ2 goodness-of-fit tests. General population data were derived from the 2006 Census, 2011 National Household Survey and 2011/12 Canadian Community Health Survey.

Results: Of 1705 total cases of ICC, 1315 were referred to BC Cancer (77.1%). Of those who were referred, 1215 (92.4%) completed HAFs. Among Indigenous women, more cases were observed (n = 85) than expected (n = 39; SR 2.16, 95% confidence interval [CI] 2.15-2.18). Among visible minorities, observed cases (n = 320) were higher than expected (n = 253; 95% CI 1.26-1.26). Elevated SRs were observed among women who self-identified as Korean (SR 1.78, 95% CI 1.76-1.80), Japanese (SR 1.77, 95% CI 1.74-1.79) and Filipino (SR 1.60, 95% CI 1.58-1.62); lower SRs were observed among South Asian women (SR 0.63, 95% CI 0.62-0.63). Elevated SRs were observed among current smokers (SR 1.34, 95% CI 1.33-1.34) and women living in rural-hub (SR 1.29, 95% CI 1.28-1.31) and rural or remote (SR 2.62, 95% CI 2.61-2.64) areas; the SR was lower among married women (SR 0.90, 95% CI 0.90-0.90).

Interpretation: Women who self-identified as visible minorities, Indigenous, current smokers, nonmarried and from rural areas were overrepresented among women with ICC. Efforts are needed to address inequities to ensure all women benefit from cervical cancer prevention.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • British Columbia / epidemiology
  • Demography
  • Early Detection of Cancer* / methods
  • Early Detection of Cancer* / statistics & numerical data
  • Female
  • Healthcare Disparities* / standards
  • Healthcare Disparities* / statistics & numerical data
  • Humans
  • Incidence
  • Middle Aged
  • Minority Health* / ethnology
  • Minority Health* / statistics & numerical data
  • Neoplasm Invasiveness
  • Neoplasm Staging
  • Preventive Health Services* / organization & administration
  • Registries / statistics & numerical data
  • Risk Factors
  • Rural Health / statistics & numerical data*
  • Smoking / epidemiology
  • Socioeconomic Factors
  • Uterine Cervical Neoplasms* / epidemiology
  • Uterine Cervical Neoplasms* / pathology

Grants and funding