Racial and regional disparities in female genital cancer mortality in the United States, 1999-2020: A CDC WONDER and joinpoint regression analysis

Document Type

Conference Proceeding

Publication Date

9-18-2025

Publication Title

Cancer Epidemiol Biomarkers Prev

Keywords

Oncology, Public, Environmental & Occupational Health

Abstract

Introduction: Female genital and reproductive cancers - malignant neoplasms of the vagina, cervix, uterus, fallopian tubes, and ovaries - are a significant source of cancer-related mortality among women in the United States (U.S.), with persistent disparities across racial and geographic groups. The International Agency for Research on Cancer (IARC) recently reported that female genital cancers account for about 15% of all female-related cancers and deaths. This study evaluates trends in female genital cancer mortality over two decades (1999-2020), stratified by race and U.S. Census region, to identify progress and gaps in cancer control efforts. Methods: Age-adjusted mortality rates (AAMRs) for female genital cancers (using ICD-10 codes C51-C58) were obtained from the CDC Wide-ranging Online Data for Epidemiologic Research (WONDER) database. Joinpoint regression analysis was used to identify statistically significant shifts in trends by race/ethnicity and U.S. Census region. Annual Percent Change (APC) and Average Annual Percent Change (AAPC) were calculated. Statistical significance was set at p < 0.05. Results: From 1999 to 2020, all four U.S. Census regions experienced a decline in female genital cancer mortality. The Northeast had the steepest decrease (AAPC: −1.05%, p < 0.001), followed by the Midwest (−0.94%, p < 0.001), South (−0.88%, p < 0.001), and West (−0.70%, p = 0.013). The West had two joinpoints, with an initial statistically insignificant increase from 1999 to 2001 (APC: +1.51%) followed by significant declines thereafter. Racial analysis revealed that Black or African American women consistently had the highest mortality, although they experienced a significant decline (AAPC: −0.71%, p < 0.001). White women also saw a notable decrease (AAPC: −0.97%, p < 0.001), while Hispanic or Latino women had a more modest decline (AAPC: −0.69%, p < 0.001). American Indian or Alaska Native women demonstrated an initial spike (APC: +27.2% from 1999–2001), followed by a sharp decline (APC: −2.41%, p < 0.001). Asian or Pacific Islander women showed no statistically significant trend over the entire period (AAPC: −0.11%, p = 0.456). Overall, trends suggest improvement in mortality rates, but plateauing and disparities persist among several groups. Conclusions: While female genital cancer mortality has declined nationally, disparities persist across racial groups and regional lines. Black women remain disproportionately affected as compared to all other races which warrants further investigation to address potential causes of disparity. Additionally, recent slowed regression in mortality among Hispanic, American Indian/Alaska Native, and Asian populations requires urgent attention. Targeted public health strategies are necessary to reduce systemic inequities and improve outcomes for all women.

Volume

34

Issue

9

First Page

C2

Find It @ Sladen

Share

COinS