Does the Intersectionality of Race/Ethnicity and Type 2 Diabetes Increase the Odds of a Cervical Cancer Diagnosis? A Nested Case-Control Study of a Florida Statewide Multisite EHR Database.
Rahma S Mkuu, Jaclyn M Hall, Zhanna Galochkina, Hee Deok Cho, Stephanie A S Staras, Ji-Hyun Lee, Yi Guo, Choeeta Chakrabarti, Sable Bowman Barrow, Selena Ortega, Daniel M Avery, John Higginbotham, Jala Lockhart, Elizabeth A Shenkman
Author Information
Rahma S Mkuu: Department of Health Science, The University of Alabama, Tuscaloosa, AL 35487, USA.
Jaclyn M Hall: Department of Health Outcomes and Biomedical Informatics, The University of Florida, 2199 Mowry Road, Gainesville, FL 32611, USA.
Zhanna Galochkina: Division of Quantitative Sciences, University of Florida Health Cancer Center, The University of Florida, 2033 Mowry Road, Gainesville, FL 32610, USA.
Hee Deok Cho: Department of Health Outcomes and Biomedical Informatics, The University of Florida, 2199 Mowry Road, Gainesville, FL 32611, USA.
Stephanie A S Staras: Department of Health Outcomes and Biomedical Informatics, The University of Florida, 2199 Mowry Road, Gainesville, FL 32611, USA.
Ji-Hyun Lee: Department of Biostatistics, The University of Florida, 2004 Mowry Road, Gainesville, FL 32603, USA.
Yi Guo: Department of Health Outcomes and Biomedical Informatics, The University of Florida, 2199 Mowry Road, Gainesville, FL 32611, USA. ORCID
Choeeta Chakrabarti: Department of Anthropology, Florida State University, 2035 E Paul Dirac Drive Suite 206, Tallahassee, FL 32310, USA.
Sable Bowman Barrow: Department of Health Outcomes and Biomedical Informatics, The University of Florida, 2199 Mowry Road, Gainesville, FL 32611, USA.
Selena Ortega: Department of Health Outcomes and Biomedical Informatics, The University of Florida, 2199 Mowry Road, Gainesville, FL 32611, USA. ORCID
Daniel M Avery: College of Community Health Sciences, The University of Alabama, 211 Peter Bryce Boulevard, Tuscaloosa, AL 35401, USA.
John Higginbotham: College of Community Health Sciences, The University of Alabama, 211 Peter Bryce Boulevard, Tuscaloosa, AL 35401, USA. ORCID
Jala Lockhart: Department of Health Science, The University of Alabama, Tuscaloosa, AL 35487, USA.
Elizabeth A Shenkman: Department of Health Outcomes and Biomedical Informatics, The University of Florida, 2199 Mowry Road, Gainesville, FL 32611, USA.
Cervical cancer and Type 2 Diabetes (T2D) share common demographic risk factors. Despite this, scarce research has examined the relationship between race/ethnicity, having T2D, and cervical cancer incidence. We analyzed statewide electronic health records data between 2012 and 2019 from the OneFlorida+ Data Trust. We created a 1:4 nested case-control dataset. Each case (patient with cervical cancer) was matched with four controls (patients without cervical cancer) without replacement by year of encounter, diagnosis, and age. We used conditional logistic regression to estimate the unadjusted and adjusted odds ratios (ORs) and 95% confidence intervals (CIs) to examine the association between race/ethnicity, T2D, and cervical cancer incidence. A total of 100,739 cases and 402,956 matched controls were identified. After adjusting for sociodemographic characteristics, non-Hispanic Black women with T2D had higher odds of cervical cancer compared with non-Hispanic White women with T2D (OR: 1.58, 95% CI 1.41-1.77). Living in a rural area, having Medicaid/Medicare insurance, and having high social vulnerability were associated with higher odds of having a cervical cancer diagnosis. Our findings imply the need to address the higher burden of cervical cancer diagnosis among non-Hispanic Black women with T2D and in underserved populations.
