EP368/#932 Ethnic disparity in cervical cancer stage at diagnosis in an Israeli referral-center

Objectives

We aimed to compare stage and stage-specific survivals of cervical cancer among Jewish and Arab women in a referral medical center in Israel

Methods

Consecutive patients with cervical cancer treated in a single institution between 2011–2021 were identified. A comparison between Jewish and Arab women included demographic, pathologic and clinical features. Factors related to advanced stage (≥2B) were determined by regression analysis. Stage-specific survival was compared using the Kaplan-Meier method

Results

Included were 288 Jewish and 66 Arab women. Histology was Squamous-cell carcinoma in 2/3 of the cases in both groups. The groups did not differ in mean BMI, age at diagnosis and menopausal status. Arab women had higher parity. Arab ethnicity was related to a higher risk of advanced stage at diagnosis (54.5% vs. 70.3%, HR 1.97, 95% CI 1.10–3.54, p=0.021). In multivariate regression analysis, older age (OR 1.02, 95% CI 1.007–1.047, p=0.008), and Arab descent (OR 2.27, 95% CI 1.05–4.89, p=0.036) were found to be associated with an advanced stage. Adenocarcinoma histology was independently negatively associated with advanced disease (OR 0.32, 95% CI 0.15–0.70, p=0.004). During median follow-up period of 25 months (interquartile range 9–97 months), 88 patients died and 35 progressed. Stage-specific survival was similar among the ethnic groups

Conclusions

Advanced stage at diagnosis was more prevalent in Arabs compared to Jewish women with cervical cancer, whereas stage-specific survival was similar. Possible attributing factors to the observed disparity, such as: health-care access, socioeconomic status, education, culture, molecular and genetic mechanisms, should be further investigated