Spatial Temporal Analysis of Public Health Surveillance: Cervical Cancer Disparities in Texas, 1990-2003
Abstract
Objective: The literature suggests that cervical cancer mortality in Texas is distributed inhomogeneously among specific demographic subgroups and in certain geographic regions over time. To understand the extent of the demographic and geographic disparities, the present study examined cervical cancer mortality in 5 demographic groups in Texas counties in a 14-years period. Methods: The Spatial Scan Statistic was used to assess the relative risk, duration and age-adjusted rates of mortality excess, and their respective p-values for testing the null hypothesis of homogeneity of geographic and temporal distribution among Texas residents by county between 1990 and 2003. Results: The study confirmed excess mortality in some Texas counties that were previously found in the literature, identified an additional excess mortality region, and detected 3 health regions with potentially persistent excess mortality involving several population subgroups. Conclusion: Health disparities of cervical cancer appears to continue to exist in Texas demographic subpopulations. Health education and intervention programs should be directed to the at-risk subpopulations in the identified regions.