Does the Intersectionality of Race/Ethnicity and Type 2 Diabetes Increase the Odds of a Cervical Cancer Diagnosis? A Nested Case–Control Study of a Florida Statewide Multisite EHR Database

Author:

Mkuu Rahma S.1,Hall Jaclyn M.2,Galochkina Zhanna3,Cho Hee Deok2,Staras Stephanie A. S.2,Lee Ji-Hyun4,Guo Yi2ORCID,Chakrabarti Choeeta5,Barrow Sable Bowman2,Ortega Selena2ORCID,Avery Daniel M.6,Higginbotham John6ORCID,Lockhart Jala1,Shenkman Elizabeth A.2

Affiliation:

1. Department of Health Science, The University of Alabama, Tuscaloosa, AL 35487, USA

2. Department of Health Outcomes and Biomedical Informatics, The University of Florida, 2199 Mowry Road, Gainesville, FL 32611, USA

3. Division of Quantitative Sciences, University of Florida Health Cancer Center, The University of Florida, 2033 Mowry Road, Gainesville, FL 32610, USA

4. Department of Biostatistics, The University of Florida, 2004 Mowry Road, Gainesville, FL 32603, USA

5. Department of Anthropology, Florida State University, 2035 E Paul Dirac Drive Suite 206, Tallahassee, FL 32310, USA

6. College of Community Health Sciences, The University of Alabama, 211 Peter Bryce Boulevard, Tuscaloosa, AL 35401, USA

Abstract

Cervical cancer and Type 2 Diabetes (T2D) share common demographic risk factors. Despite this, scarce research has examined the relationship between race/ethnicity, having T2D, and cervical cancer incidence. We analyzed statewide electronic health records data between 2012 and 2019 from the OneFlorida+ Data Trust. We created a 1:4 nested case–control dataset. Each case (patient with cervical cancer) was matched with four controls (patients without cervical cancer) without replacement by year of encounter, diagnosis, and age. We used conditional logistic regression to estimate the unadjusted and adjusted odds ratios (ORs) and 95% confidence intervals (CIs) to examine the association between race/ethnicity, T2D, and cervical cancer incidence. A total of 100,739 cases and 402,956 matched controls were identified. After adjusting for sociodemographic characteristics, non-Hispanic Black women with T2D had higher odds of cervical cancer compared with non-Hispanic White women with T2D (OR: 1.58, 95% CI 1.41–1.77). Living in a rural area, having Medicaid/Medicare insurance, and having high social vulnerability were associated with higher odds of having a cervical cancer diagnosis. Our findings imply the need to address the higher burden of cervical cancer diagnosis among non-Hispanic Black women with T2D and in underserved populations.

Funder

University of Florida Clinical and Translational Science Institute

Publisher

MDPI AG

Subject

Health Information Management,Health Informatics,Health Policy,Leadership and Management

Reference47 articles.

1. Center for Disease Control and Prevention (2023, May 25). Cervical Cancer Statistics, Available online: https://www.cdc.gov/cancer/cervical/statistics/index.htm.

2. Diabetes and Cancer: A consensus report;Giovannucci;Diabetes Care,2010

3. Diabetes and cancer;Vigneri;Endocr. Relat. Cancer,2009

4. Linking type 2 diabetes and gynecological cancer: An introductory overview;Anastasi;Clin. Chem. Lab. Med. CCLM,2018

5. The Association between Type 2 Diabetes Mellitus and Women Cancer: The Epidemiological Evidences and Putative Mechanisms;Joung;BioMed Res. Int.,2015

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