Health care disparities and cervical cancer

Objectives. We compared cervical cancer incidence, stage at diagnosis, and survival in Medicaid-insured and non-Medicaid-insured populations. Methods. We stratified the sample by age and used ordered logistic regression to predict stage at diagnosis and used Cox proportional hazards regression to predict survival. Results. Medicaid insured nearly one quarter of women diagnosed with cervical cancer. The likelihood of late-stage disease was greatest for women who enrolled in Medicaid after diagnosis. Women younger than 65 years who enrolled in Medicaid after diagnosis were more likely to die from cervical cancer than were women who were not insured by Medicaid (hazard ratio = 2.40, 95% confidence interval = 1.49, 3.86). Conclusions. Our study underscores the importance of cervical cancer screening programs targeted at low-income women.