Abstract C158: Disparities in stage at diagnosis for female reproductive cancers by race and ethnicity and urbanicity in the U.S., 2012–2022

Abstract

Stage at diagnosis is informed by when cancer is detected and one of the strongest prognostic factors for survival. Disparities in diagnosis stage result from inequities in access to quality medical care, which disproportionately impact racial and ethnic minoritized populations and people in less urban areas. Estimate independent and joint associations of race and ethnicity and urbanicity on diagnosis stage for female reproductive cancers (cervix, uterus, ovary, vagina, vulva). We used 2012-2022 data from the Surveillance, Epidemiology, and End Results (SEER) 21 database, excluding 2020 (N=405,072). We examined the impact of race and ethnicity (Non-Hispanic [NH] American Indian and Alaska Native [AIAN]; NH Asian; NH Pacific Islander; NH Black; Hispanic [all races]; and NH White) and urbanicity (non-metropolitan counties and metropolitan counties) on diagnosis stage (localized vs. regional and/or distant). We conducted logistic regression to estimate odds ratios (OR) for the association between race and ethnicity and urbanicity, separately, on diagnosis stage for each cancer site, adjusted for age, diagnosis year, cancer registry, and county-level median household income. We then stratified the race and ethnicity model by urbanicity. For cervix, all racial and ethnic groups had significantly higher odds of diagnosis at the regional versus localized stage compared to NH White women; NH Black (OR=1.40) and NH Pacific Islander (OR=1.96) women had higher odds of distant stage diagnosis, while NH Asian women (OR=0.77) had lower odds of distant stage diagnosis. For uterus, all groups except NH AIAN women had higher odds of both regional and distant stage diagnoses compared with NH White women. For ovary, NH Asian (OR=1.14) and NH Pacific Islander (OR=1.45) women had higher odds of regional stage diagnosis; NH AIAN (OR=1.37), NH Black (OR=1.23), and Hispanic (OR=1.09) women had higher odds of diagnosis at the distant stage. For vagina, NH AIAN women (OR=0.38) had lower odds of diagnosis at the regional or distant stage than the localized stage compared to NH White women, while Hispanic women (OR=1.22) had higher odds of regional or distant stage diagnosis. For vulva, NH Black (OR=1.19) and Hispanic (OR=1.19) women had higher odds of regional or distant stage diagnosis. Women living in non-metropolitan counties had higher odds of distant stage diagnosis than localized stage for cervical cancer (OR=1.16) compared with those in metropolitan counties. The only significant difference found in the urbanicity stratified analyses within each racial and ethnic group was for uterine cancer among NH AIAN women diagnosed at the distant stage (ORMetro=0.99, 95%CI 0.77, 1.27; ORNon-metro=1.92, 95%CI 1.32, 2.80). We observed disparities in later stage diagnosis for multiple female reproductive cancers by race and ethnicity, while disparities by urbanicity were only observed for cervical cancer. These findings may reflect differential access to and utilization of healthcare and warrant further investigation. Beth J. Maclin, Angelina Cho, Melissa Buffalo, Lindsay J. Collin, Kemi M. Doll, Natalie S. Joe, Aimée R. Kreimer, Wayne R. Lawrence, Jaimie Z. Shing, Meredith S. Shiels. Disparities in stage at diagnosis for female reproductive cancers by race and ethnicity and urbanicity in the U.S., 2012–2022 [abstract]. In: Proceedings of the 19th AACR Conference on the Science of Cancer Health Disparities; 2026 Oct 18-21; Atlanta, GA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2026;35(10 Suppl):Abstract nr C158.