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= Breast and Gynecologic Cancer Disparities in the United States = Each section focuses on a different cancer type under the umbrella of breast and gynecologic cancers and will include discussion of disparities in care for each cancer type that are based on socioeconomic, racial/ethnic, geographical, sexual orientation factors.

Interventions to Address Disparities
= Annotated Bibliography = [1] Collins, Yvonne. “Gynecologic cancer disparities: A report from the Health Disparities Taskforce of the Society of Gynecologic Oncology.” Gynecologic Oncology 133, 2 (2014): 353-361.

''This article discusses how the etiology of disparities in female cancers such as ovarian cancer, endometrial cancer, and cervical cancer is complex. The study breaks down underlying causes into 3 categories: systemic factors (health care delivery, hospital systems in different geographical areas, etc.), provider factors (cultural beliefs that impact clinical decisions, lack of ethnic and racial diversity and awareness amongst medical providers), and patient factors (cultural, educational, socioeconomic, and geographical influences).''

[2] Bigby, Judy. “Disparities across the Breast Cancer Continuum.” Cancer Causes and Control 16, 1 (2005): 35-44.

This journal article investigates how disparities in breast cancer care have been documented across several domains in the breast cancer care continuum: risk, incidence, screening, diagnosis, treatment, access to clinical trials, survival, and mortality.

[3] Polacek, Georgia. “Breast cancer disparities and decision-making among U.S. women.” Patient Education and Counseling 65, 2 (2007): 158-165.

''This article investigates how differences in treatment choice affect outcomes. They found that treatment decision-making is complex and is resultant of multiple interacting factors including social and economic realities. These differences may contribute to breast cancer disparities in the U.S.''

[4] Yost, K. “Socioeconomic status and breast cancer incidence in California for different race/ethnic groups.” Cancer Causes Control 12 (2001): 703-711.

A strong relationship between breast cancer incidence and socioeconomic position, varying to some degree by race and ethnicity, was established.

[5] Ayanian, J. “The relation between health insurance coverage and clinical outcomes among women with breast cancer.” New England Journal of Medicine  392 (1993): 326-331.

''Women with insurance have a higher rate of survival than do women without insurance and with Medicaid. This is because women who qualify for Medicaid often have a later stage of disease than other women.''

[6] McDavid, K. “Cancer survival in Kentucky and health insurance coverage.” Arch Intern Med 163 (2003): 2135-2144.

[7] Bradley, C. “Disparities in cancer diagnosis and survival.” Cancer 91 (2001): 178-188.

[8] Peek, M. “Disparities in screening mammography: current status, interventions and implications.” J Gen Intern Med 19 (2004): 184-194.

This study found low-income women to have mammography screening rates that are 24% lower than higher income women.

[9] Gomez, Scarlett. “Hidden Breast Cancer Disparities in Asian Women: Disaggregating Incidence Rates by Ethnicity and Migrant Status.” American Journal of Public Health 100, 1 (2010): 125-131.

[10] Swansonn, G. “Breast cancer among young African- American women: a summary of data and literature and of issues discussed during the summit meeting on breast cancer among African American women.” Cancer 97 (2000): 273-279.

This article found that black and American-Indian women have the lowest breast cancer survival rates of all women in the U.S. Black women with breast cancer are twice as likely to die from their cancer within 5 years than white women.

[11] Griggs, J. “Racial disparity in the dose and dose intensity of breast cancer adjuvant chemotherapy.” Breast Cancer Res Treat 81 (2002): 21-31.

''This study found that different reproductive factors such as first full term pregnancy and lower breast feeding rate of black women compared to white women could potentially explain different risk levels for breast cancer. Higher rates of obesity amongst African Americans also seem to explain a great deal of racial disparities in breast cancer.''

[12] Clegg, L. “Cancer survival among U.S. whites and minorities.” Arch Intern Med 162 (2002): 1985-1993.

[13] Krieger, N. “Geocoding and monitoring of US socioeconomic inequalities in mortality and cancer incidence: does the choice of area-based measure and geographic level matter.” American Journal of Epidemiology 156 (2002): 471-482.

[14] Krieger, N. “Race/ethnicity, gender, and monitoring socioeconomic gradients in health: a comparison of area-based socioeconomic measure – the Public Health Disparities Geocoding Project.” American Journal of Public Health 93 (2003): 1655-1671.

[15] Singh, GK. “Area Socioeconomic Variations in US Cancer Incidence, Mortality, Stage, Treatment and Survival, 1975-1999.” National Cancer Institute (2003).

[16] Bigby, Judy. “Disparities across the Breast Cancer Continuum.” Cancer Causes and Control 16, 1 (2005): 35-44.

[17] Brown, Jessica. “Lesbians and cancer: an overlooked health disparity.” Cancer Causes and Control 19 (2008): 1009-1020.

''The study found that compared to heterosexual women, lesbians have more sexual risk factors for cervical cancer. Poor patient-provider communication is at the root of the problem that lesbian women are not getting screened adequately.''

[18] Miller, Jacqueline. “Public health national approach to reducing breast and cervical cancer disparities.” Cancer 120, 16 (2014): 2537-2539.

''The article discusses how the Centers for Disease Control and Prevention (CDC) established the National Breast and Cervical Cancer Early Detection Program (NBCCEDP) to provide breast and cervical cancer screening, diagnostic tests and treatment to low-income women. The article argues for establishing a comprehensive programmatic system by ensuring a continuum of care.''

[19] Singh, Gopal. “Persistent area socioeconomic disparities in U.S. incidence of cervical cancer, mortality, stage, and survival, 1975-2000.” Cancer 101 (2004): 1051-1057.

[20] Katz, SJ. “Socioeconomic disparities in preventative care persist despite universal coverage: breast and cervical cancer screening in Ontario and the United States.” JAMA (1994).

[21] Newmann, Sara. “Social inequities along the cervical cancer continuum: a structured review.” Cancer Causes and Control 16 (2005): 63-70.

''Screening rates, incidence, and mortality rates of cervical cancer are higher among black women than among their white counterparts. The study found women from minority racial or ethnic backgrounds were diagnosed at a later, more advanced stage than white women.''

[22] Singh, Gopal. “Persistent area socioeconomic disparities in U.S. incidence of cervical cancer, mortality, stage, and survival, 1975-2000.” Cancer 101, 5 (2004): 1051-1057.

[23] Freedman, HP. “Excess Cervical Cancer Mortality: A marker for low access to health care in poor communities.” National Cancer Institute, Center to Reduce Cancer Health Disparities (2005).

[24] Hoffman, Jan. “Wider Racial Gap Found in Cervical Cancer Deaths.” New York Times (2017).

[25] Brown, Jessica. “Lesbians and cancer: an overlooked health disparity.” Cancer Causes and Control 19 (2008): 1009-1020.

[26] O’Brien, MJ. “Community health worker intervention to decrease cervical cancer disparities in Hispanic women.” Journal of General Internal Medicine 25 (2010): 1186-1192.

[27] Fouad, MC. “The development of a community action plan to reduce breast and cervical cancer disparities between African-American and white women.” Ethnicity and disease 14 (2004): 53-60.

[28] Mercado, Zingmond. “Quality of care in advanced ovarian cancer: the importance of provider speciality.” Gynecologic Oncology 117 (2010): 18-22.

[29] Parham, Phillips. “The National Cancer Database Report on Malignant Epithelial Ovarian Carcinoma in African-American Women. Cancer 80 (1997): 815-826.

[30] Merril, RM. “Racial/ethnic differences in the use of surgery for ovarian cancer in the United States.” Advanced Medical Science 55 (2010): 93-98.

[31] Dolecek, Kim. “Racial differences in stage at diagnosis and survival from epithelial ovarian cancer: a fundamental cause of disease approach.” Social Science Medicine 71 (2010): 274-281.

[32] Barnhotz-Sloan, J. “Ovarian cancer: changes in patterns at diagnosis and relative survival over the last three decades.” American Journal of Obstretrics and Gynecology 189 (2003): 1120-1127.

[33] Aranda, MA. “Do racial/ethnic disparities exist in the utilization of high-volume surgeons for women with ovarian cancer?” Gynecologic Oncology 111 (2008): 166-172.

[34] Liu, Rebecca. “Relationship between race and interval to treatment in endometrial caner.” Obstretrics and Gynecology 86 (1995): 486-490.

The article found that black women, when compared to white women, with endometrial cancer had a significantly higher incidence of unfavorable features (non-endometrioid histology), stage III or IV disease, high stage differentiation, and poor survival.

[35] Long, B. “Disparities in uterine cancer epidemiology, treatment, and survival among African Americans in the United States.” Gynecologic Oncology  130 (2013): 652-659.

[36] Allard, J. “Race disparities between black and white women in the incidence, treatment, and prognosis of endometrial cancer.” Cancer Control Journal 16 (2009) 53.

[37] Maxwell, GI. “Racial disparity in survival among patients with advanced/recurrent endometrial adenocarcinoma.” Cancer (2006).

[38] Benard, Vicki. “Examining the association between socioeconomic status and potential human papillomavirus-associated cancers.” Cancer 113 (2008): 2910-2918.

''This study discusses how vaginal cancer is HPV-associated, and that there have been studies associating certain socioeconomic factors with higher risk for HPV. It has many of the same risk factors as cervical cancer.''

[39] Kahn, Jessica. “Sociodemographic Factors Associated with High-Risk Human Papillomavirus Infection.” Obstrerics and Gynecology 110 (2007): 87-95.

''The results of their study revealed that the correlation between African Americans and HPV infection may be due to to the fact that black women living above the poverty line in the study had a lower mean income and were less likely to be married that white women also above the poverty women. For women higher than the poverty line, factors such as African American race, lower income, unmarried status, and younger age were associated with HPV infection.''

[40] Wu, Xiaocheng. “Descriptive epidemiology of vaginal cancer incidence and survival by race, ethnicity and age in the United States.” Cancer 133 (2008): 2873-2882.

This study found that black, Asian Pacific Islander, and Hispanic women and older women had a significantly high portion of late-stage vaginal cancer and a low five-year survival rate.

[41] Hain, Rauh. “Racial disparities and changes in clinical characteristics and survival for vulvar cancer over time.” American Journal of Obstretrics and Gynecology 209 (2013): 468.

The study found that African Americans presented with vulvar cancer at a significantly younger age than white women and had better survival.