Date of Conferral

2022

Degree

Doctor of Public Health (DrPH)

School

Public Health

Advisor

Vasileios V. Margaritis

Abstract

Despite breakthroughs and improvement in cervical cancer (cercancer) management strategies over the years, racial and geographical disparities on 5-year relative survival rates (RSRs) persist. Studies showed black women have higher mortality rates than white women with the majority of deaths occurring among women above age 45. The aim of this cross-sectional study was to investigate the predicting abilities of race and residence on 5-year RSRs by stage at diagnosis and the potential effect on survival probability in the early stage of cercancer for women above 45 years living in Georgia. Anderson's behavioral model for inequalities in healthcare was the theoretical framework of the study. A total of 2,811 cercancer patients residing in rural and urban locations who were diagnosed with cercancer between 1992 and 2016 were sampled from the Surveillance, Epidemiology, and End Results Program dataset. Data were analyzed using the Cox regression model. Age, treatment, and marital status accounted for the racial and residential-based differences in all stages and early-stage cercancer 5-year RSRs. Aging increased hazard rate and decreased patient survival time. Being married (including common law), unlike living with a domestic partner or being widowed, reduced the hazard rate and extended individual survival time. Additionally, conventional cancer treatment approaches increased cercancer hazard rate and reduced survival time. According to the study results, positive social change can be achieved by acknowledging that a shift of attention in policy guidelines from race and residence-based considerations to age, treatment, and marital status is essential in tailoring interventions towards addressing survival disparities.

Download

Share

 
COinS