Low Socioeconomic Status New York City Neighborhoods Associated With Cervical Cancer Incidence Disparities

Cervical cancer incidence rates were significantly higher in the lowest-socioeconomic status neighborhoods vs the highest-socioeconomic status neighborhoods in New York City.

The lowest-socioeconomic status (SES) neighborhoods in New York City, populated primarily with Black and Hispanic individuals, had an incidence of cervical cancer that was 73% higher than the highest-SES neighborhoods in New York, which mostly consisted of White individuals (interdecile incidence rate ratio, 1.73; 95% CI, 1.52-1.96; P < .001), according to research published in JAMA Oncology.

The higher cervical cancer incidence rate in lower-SES neighborhoods than higher-SES neighborhoods corresponded with incidence rates of 11.2 cases (95% CI, 10.3-12.2) and 6.5 cases (95% CI, 5.9-7.1) per 100,000 woman-years, respectively.

Age-standardized incidence rates of cervical cancer varied across New York City neighborhoods, ranging from 4.4 cases (95% CI, 2.9-7.4) to 14.7 cases (95% CI, 10.8-19.5) per 100,000 woman-years. Investigators highlighted substantial variations in self-reported socioeconomic and demographic factors between neighborhoods. When evaluating neighborhoods with the highest SES values, the population included a majority of White residents (68.9%), with a minority of Hispanic (11.6%) and Black residents (4.5%). For neighborhoods with the lowest SES values, the population included a majority of Hispanic residents (60.1%) and Black residents (33.5%), with fewer White residents (3.0%).

“In the United States, access to health care services is linked to socioeconomic status and has been implicated in contributing to health disparities,” the investigators wrote. “New York, the US’s most densely populated major city, exhibits significant racial and socioeconomic inequities.”

This population-based, cross-sectional study abstracted cervical cancer cases and age-standardized incidence rates by New York City neighborhoods, with neighborhoods defined using the Public Use Microdata Areas of the 2010 decennial census. Cases and incidence rates came from the New York State Cancer Registry and were linked with self-reported data from the United States Census Bureau’s American Community Survey.

Data analysis occurred from July 1 to October 16, 2020. Measures, validated by the Agency for Healthcare Research and Quality including crowding, real-estate values, poverty rates, incomes, educational attainment, and unemployment, were utilized to calculate an SES score for each neighborhood.

From January 1, 2012 to December 31, 2016, 932 cases of cervical cancer in 55 New York City neighborhoods, which corresponded with an age-standardized incidence rate of 9.1 cases per 100,000 woman-years (95% CI, 8.7-9.5).

“The findings of this study suggest that scalable, evidence-based interventions that incorporate community and sociocultural context may be especially important to promoting prevention, vaccination, and early detection and to reduce disparities in diverse urban centers with large immigrant populations,” the study’s authors concluded.

Reference

Cham S, Li A, Rauh-Hain JA, et al. Association between neighborhood socioeconomic inequality and cervical cancer incidence rates in New York City. JAMA Oncol. Published online November 24, 2021. doi:10.1001/jamaoncol.2021.5779