Cancer Causes & Control

, Volume 29, Issue 4–5, pp 445–453 | Cite as

A spatiotemporal analysis of invasive cervical cancer incidence in the state of Maryland between 2003 and 2012

  • Sally Peprah
  • Frank C. Curreiro
  • Jennifer H. Hayes
  • Kimberly Stern
  • Shalini Parekh
  • Gypsyamber D’Souza
Original paper
  • 81 Downloads

Abstract

Purpose

Invasive cervical cancer (ICC) rates have tremendously declined in the United States, yet new cases consistently occur in Maryland and throughout the United States. We hypothesized that although rates have generally declined, this decline is uneven across counties and over time.

Methods

Space–time cluster detection analysis was conducted to evaluate clusters of ICC incidence at the county level within Maryland between 2003 and 2012.

Results

The most likely cluster was a cluster of low incidence, which included 6 counties in eastern Maryland for the period 2009–2012. A secondary cluster of low rates, comprising 2 metropolitan counties in northern Maryland, was observed for the period 2009–2012. Two of the three clusters of high ICC rates occurred in 2009–2012 in the large metropolitan area of Baltimore City and another cluster in Frederick County, in rural western Maryland. The third cluster of high rates was observed 2005–2008, in western Maryland.

Conclusion

In recent periods, some Maryland counties have experienced anomalously high or low ICC incidence. Clusters of high incidence are not explained by differences in screening rates and may be due to failures in follow-up care for cervical abnormalities that need to be investigated. Clusters of low incidence may represent areas of successful ICC control.

Keywords

Space–time cluster detection Spatial epidemiology Cervical cancer Cancer surveillance SaTScan 

Notes

Acknowledgments

We acknowledge the State of Maryland, the Maryland Cigarette Restitution Fund, and the National Program of Cancer Registries of the Centers for Disease Control and Prevention for the funds that support the collection and availability of the cancer registry data. The findings and conclusions of this study do not necessarily represent views of the Maryland Cancer Registry.

Compliance with ethical standards

Conflict of interest

The authors declare no potential conflicts of interest.

Ethical approval

The Institutional Review Boards of Johns Hopkins School of Public Health and the Maryland Department of Health and Mental Hygiene approved this study.

Supplementary material

10552_2018_1019_MOESM1_ESM.docx (61 kb)
Supplementary material 1 (DOCX 60 KB)
10552_2018_1019_MOESM2_ESM.png (1.9 mb)
Supplemental Figure 1. Choropleth map of average annual crude incidence of invasive cervical cancer per 100,000 women by county in Maryland, 2003-2012 (PNG 1926 KB)

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Sally Peprah
    • 1
  • Frank C. Curreiro
    • 1
  • Jennifer H. Hayes
    • 2
  • Kimberly Stern
    • 2
  • Shalini Parekh
    • 2
  • Gypsyamber D’Souza
    • 1
  1. 1.Department of EpidemiologyJohns Hopkins Bloomberg School of Public HealthBaltimoreUSA
  2. 2.Maryland Cancer Registry, Center for Cancer Prevention and ControlMaryland Department of Health and Mental HygieneBaltimoreUSA

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