Résumé :
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[BDSP. Notice produite par INIST-CNRS R0xAtl88. Diffusion soumise à autorisation]. Objectives. We examined the relationship of age at diagnosis and insurance status with stage among cervical cancer patients aged 21 to 85 years. Methods. We selected data on women (n=69739) diagnosed with invasive cervical cancer between 2000 and 2007 from the National Cancer Database. We evaluated the association between late stage (stage III/IV) and both insurance and age, with adjustment for race/ethnicity and other sociodemographic and clinical factors. We used multivariable log binomial models to estimate risk ratios (RRs) and 95% confidence intervals (CIs). Results. The proportion of late-stage disease increased with age : from 16.53% (21-34 years) to 42.44% (>=70 years). The adjusted relative risk of advanced-stage disease among women aged 50 years and older was 2.2 to 2.5 times that of patients aged 21 to 34 years. Uninsured (RR=1.44 ; 95% CI=1.40,1.49), Medicaid (RR=1.37,95% CI=1.34,1.41), younger Medicare (RR=1.12,95% CI=1.06,1.19), and older Medicare (RR=1.20,95% CI=1.15,1.26) patients had a higher risk of late-stage disease than did privately insured patients. Conclusions. Screening should be encouraged for women at high risk for advanced-stage disease.
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