Trichomonas vaginalis in Vanuatu

OBJECTIVE: To assess the prevalence of Trichomonas vaginalis in two island populations of Vanuatu using the Pap smear as the screening technique. STUDY DESIGN: Women were randomly selected from specific sites on the islands of Efate (urban setting) and Ambae (rural setting). Pap smears were collected, screened and reported. SETTING: The first collection site was the Women's Health/Antenatal Care Clinic at Vila Central Hospital in Port Vila, the capital city located on the island of Efate, and the second collection site was a rural village on a sparsely populated inhabited northern island, Ambae. PARTICIPANTS: A total of 905 Ni-Vanuatu women participants: Efate (n = 562) 62%, and Ambae (n = 343) 38%. The mean age was 35.8 years: Efate 32.6 years, and Ambae 40.8 years. MAIN OUTCOME MEASURE: The presence or absence of T. vaginalis in these Pap smears was documented during the study's cervical screening process. RESULTS: The overall prevalence of T. vaginalis within the study participants was 25.3%. Almost half of the infected sample group were in the age group of 30-39 years (43.8%). The prevalence of T. vaginalis in Efate was 14.7%, compared with 43.4% in Ambae. CONCLUSION: The prevalence of T. vaginalis in Vanuatu women is significantly higher compared with developed countries. Women in rural settings are less likely to have access to sexually transmitted disease prevention and treatment programs, thus contributing to high infection rates compared with women in urban settings. Cultural and educational differences in the rural setting might also contribute to higher sexually transmitted disease rates among these women.     

1998～2003年湖北省妇女病患病情况分析

目的 :了解我省已婚妇女生殖系统患病情况及变化趋势。方法 :1998～ 2 0 0 3年全省市、县、区妇幼保健机构对辖区 <65岁已婚妇女进行妇女病普查 ,并逐级汇总上报到省。结果 :①城市与农村的患病率有明显差异 ,农村滴虫性阴道炎、宫颈癌患病率高于城市 ,城市淋病、尖锐湿疣、乳腺癌患病率高于农村。②全省妇女生殖系统感染患病率呈下降趋势 ,而宫颈癌和乳腺癌患病率呈上升趋势。③城乡妇女病普查率均偏低 ,仅 3 0 %左右。     

Cervical Cancer Risk as a Predictor of Pap Smear Use in Rural North Carolina

Risk for invasive cervical cancer is reported to be higher in rural areas than urban ones, and cervical cancer-related mortality is higher in rural women due to poorer utilization of preventive services and subsequent presentation at late stages of the disease. This cross-sectional study examined the relationship between prevalence of risk factors for cervical cancer and the degree of compliance with risk-appropriate screening guidelines for cervical cancer. Secondary data were analyzed for 614 women from Robeson County, NC, aged 40 and older, and of mainly rural and low socioeconomic status. High-risk status was determined by the presence of any of the following five risk factors: a history of more than two sexual partners, age at first sexual intercourse under 18 years, history of sexually transmitted disease, history of sexually transmitted disease in sexual partner(s), and smoking. Low-risk status was the absence of all factors. A high-risk participant was considered compliant if she had had at least three Pap smears in the 3 years prior to the interview, while a low-risk participant was considered compliant if she had had at least one Pap smear within the previous 3 years. Overall, 82% of the participants were at high risk for cervical cancer. However, only 41% of all participants were compliant with the risk-appropriate screening guidelines. Low-risk status was significantly associated with compliance with cervical cancer screening guidelines (adjusted OR = 6.7; 95% CI = 3.7 to 11.1, p = .0001). Findings in this study population suggest rural women at high risk for cervical cancer are less likely to be compliant with appropriate Pap smear screening guidelines, indicating the need to target educational programs.     

Planning for human papillomavirus (HPV) vaccination in sub-Saharan Africa: A modeling-based approach

Background

Human papillomavirus (HPV) vaccines have the potential to reduce cervical cancer incidence and mortality, particularly in the parts of the developing world that bear the greatest burden of disease. This research sought to predict the impact and cost-effectiveness of an HPV vaccination program in an example low-resource country with a high burden of cervical cancer: Mali, West Africa.

Methods

Novel compartmental mathematical models projected the impact of adolescent HPV vaccination in urban and rural areas of Mali. The models accounted for two high-risk vaccine-types: HPV 16 and 18. We then attached comprehensive real cost and cost-effectiveness estimates.

Results

Our models predict that HPV vaccination in Mali will reduce cervical cancer burden by a factor roughly equal to vaccine coverage. A point vaccination program was simulated in a cohort of 333,146 urban and 588,982 rural Malian women, age 10–14. Vaccination of 50% of girls reduced the peak prevalence of HPV 16/18 to 5.0% in the urban setting and 9.6% in the rural setting, down from 11.7% and 22.0%, respectively, with no vaccination. The 50% vaccination scenario averted 1145 cervical cancer deaths in the urban group and 2742 in the rural group. The cost per discounted life-year saved in this scenario was 1030 US dollars (urban) and 725 dollars (rural). The cost per life-year saved was higher at 90% coverage, but was still in the range of a “cost-effective” public health intervention.

Conclusions

This research yielded the most comprehensive real cost estimates of HPV vaccination yet published for sub-Saharan Africa. Our models indicate that HPV vaccination in Mali will be cost-effective when introduced. To maximize the benefit using limited resources, vaccination programs may begin with a target coverage of about 50%. We anticipate that costs of reaching late adopters after the First Vaccinated Wave of vaccination will be higher, but worthwhile.     

Prevalence of genital HPV infection in urban and rural women in the Eastern Brazilian Amazon

This study investigated the prevalence and risk factors for genital infection with HPV in women from rural and urban areas in two different regions of the Eastern Brazilian Amazon. A cross-sectional survey was performed in Pap screening programs, with a total sample of 444 women (233 urban and 211 rural). Uterine cervical swabs were collected for the detection of HPV DNA with the established PCR assay using MY09-MY11. All volunteers answered an epidemiological questionnaire. Bivariate and multivariate logistic regression analyses were performed to identify risk factors associated with HPV infection. Overall prevalence of HPV infection was 14.6% (15% in urban women and 14.2% in rural). The only factor associated with HPV was marital status in the 13-25-year-old rural population, with higher HPV prevalence among single and divorced women and widows. The findings indicate the need for risk factor control strategies targeted specifically to women in rural and urban areas.     

2006～2009年健康体检人群宫颈细胞学筛查结果分析

目的:探讨健康体检人群宫颈细胞学筛查的意义及存在问题。方法:回顾性分析2006～2009年健康体检人群宫颈细胞学筛查结果。结果:2006～2009年共33 605例宫颈细胞学检查,其中液基细胞学2 970例(8.8%),上皮细胞异常280例(0.83%),微生物阳性841例(2.50%);连续两年以上行宫颈细胞学筛查20 086例,连续两年以上上皮细胞异常33例次(21.57%)、念珠菌阳性98例次(21.40%)、滴虫阳性15例次(62.50%)。结论:健康体检人群中宫颈细胞学筛查能够早期发现上皮细胞异常,有助于预防宫颈癌的发生;传统巴氏涂片仍是宫颈癌筛查主要方法,应当加强该技术的培训与质控;持续性上皮细胞异常和微生物感染在健康体检人群中所占比例较高,需要加强对该人群随访。     

某市妇女子宫颈癌筛查及HPV疫苗认知调查

目的 了解山西省某市城乡居民在子宫颈癌筛查以及接受人乳头瘤病毒(HPV)疫苗接种的情况.方法 采用整群抽样调查方法,对某市城区和农村≥25岁女性进行子宫颈癌筛查并对HPV疫苗接受情况进行调查.结果 共调查2269名女性,其中城市居民341人,农村居民1928人;有43.4%的城区和76.5%的农村女性知晓子宫颈癌,72.4%的城区和78.9%的农村女性了解子宫颈癌筛查的目的,23.8%的城市和6.1%的农村女性知晓HPV的传播途径,78.3%的城区和92.2%的农村女性愿意支付部分筛查产生的费用,且愿意支付的费用在每人100元以内;而对预防子宫颈癌的HPV疫苗,仅有50.7%城区和34.6%农村女性愿意接种,不愿意接种的主要原因是价格因素.结论 降低子宫颈癌筛查和接种HPV疫苗的费用,或及早实现HPV疫苗生产的国产化以降低价格,加大人群子宫颈癌防治的宣传教育,对子宫颈癌的防治有重要意义.     

Visual Inspection with Acetic Acid (VIA) Screening Program: 7 Years Experience in Early Detection of Cervical Cancer and Pre-Cancers in Rural South India

Cervical cancer continues to be a major public health problem in India in the absence of wide spread organised cervical screening programs. Visual inspection of the cervix with acetic acid (VIA) is an effective, inexpensive screening test that can be combined with simple treatment procedures for early cervical lesions, provided by trained health workers. We report 7 years experience in early detection of cervical cancer and pre-cancers using the VIA test in a community-based program in rural Andhra Pradesh, India where there are no existing organised cervical screening programs.

Materials and Methods:

Eligible women aged between 26 and 60 were opportunistically screened by trained health wor kers using the VIA test. Women who tested positive were further evaluated and those with cervical lesions were treated either by cryotherapy in the screening clinic or referred to a higher center.

Results:

A total of 18,869 women were screened by a single round of VIA testing with a positive rate of 10.75%. Biopsy proven high-grade squamous intraepithelials (HSILs) were 90 (0.48%) and low-grade squamous intraepithelials (LSILs) were 43 (0.28%). The overall prevalence of cervical intraepithelial neoplasia (CIN) 2+ lesion rate is 1.05%. A total of 312 (1.65%) cryotherapies were done and 49 women underwent hysterectomy.

Conclusions:

VIA by trained female health workers is a safe, acceptable, and effective test that can save lives from cervical cancer even in remote areas with few resources. These results have important implications for efficient service delivery in cervical screening programs in low-resourced settings.     

2014-2016年贵州省农村妇女宫颈癌检查项目结果分析

目的 分析贵州省农村妇女宫颈癌检查项目结果,了解项目实施情况。方法 通过妇幼重大公共卫生项目信息直报系统,对贵州省2014-2016年农村妇女宫颈癌检查项目的数据进行分析。结果 2014-2016年实际检查人数1 472 421例,检查率为100.32%,其中2016年检查率100.33%(491 597/490 000),高于2014年100.07%(490 361/490 000)和2015年100.09%(490 463/490 000)。3年共检查出生殖道感染455 493人次,检出率为30.93/100人次(455 493/1 472 421);组织病理学应查12 487人次,实查11 079人次,宫颈病理检查随访率88.72%(11 079/12 487)。2015和2016年的宫颈低级别病变的检出率均低于宫颈高级别病变的检出率。结论 2014-2016项目的检查率在逐步提高,但是,我们要重视生殖道感染患病情况,完善初筛检查方式,提高病理诊断能力,加强阳性的追踪管理。     

2015年江苏省子宫颈癌流行现状及趋势分析

目的 分析江苏省2015年子宫颈癌发病和死亡情况及2006-2015年子宫颈癌流行趋势,为开展子宫颈癌防治工作提供科学依据。方法 利用2018年江苏省疾控中心收集并质控后的35个肿瘤登记处的2015年子宫颈癌登记资料,按城市和农村地区分层,分别计算粗发病率、年龄别发病率、累计发病率（0～74岁）、粗死亡率、年龄别死亡率、累计死亡率（0～74岁）、中国人口标化率（中标率）、世界人口标化率（世标率）等指标;采用Joinpoint软件分析江苏省2006-2015年子宫颈癌发病（死亡）中标率的平均年度变化百分比（AAPC）及其95%可信区间（95%CI）。结果 江苏省2015年子宫颈癌估算新发病例数为6610例,粗发病率为17.53/10万,中标率为12.13/10万,世标率为11.22/10万,累积发病率（0~74岁）为1.19%,在女性恶性肿瘤发病顺位中居第6位。估计子宫颈癌死亡1905例,粗死亡率为5.05/10万,中标率为3.01/10万,世标率为2.87/10万,累积死亡率（0~74岁）为0.31%,在女性恶性肿瘤死亡顺位中居第8位。2006至2015年间江苏省子宫颈癌发病和死亡水平均呈明显上升趋势,发病和死亡中标率的AAPC分别为6.6%（95%CI:4.7～8.4）和5.5%（95%CI:2.9～8.2）。结论 子宫颈癌是江苏省女性的常见恶性肿瘤,其发病与死亡率逐年明显上升,且农村地区发病和死亡水平高于城市地区,应有针对性加强子宫颈癌综合防制工作。     

2010—2018年安徽省宫颈癌发病与死亡趋势分析

目的 分析安徽省肿瘤登记地区2010—2018年女性宫颈癌发病和死亡趋势变化情况,为制定宫颈癌防治策略提供基础数据。方法 将安徽省2010—2018年各肿瘤登记处上报数据按照地区（城乡）计算宫颈癌发病率、死亡率,分别计算中国人口和世界人口标化发病/死亡率,进行发病率和死亡率的年度趋势分析。结果 安徽省2010—2018年宫颈癌发病粗率为15.94/10万,中标率为11.92/10万,呈现上升趋势（AAPC=6.91%,P<0.05）,年度变化有统计学意义;城市组发病粗率为15.34/10万,中标率为12.04/10万,呈现出上升趋势（AAPC=2.86%,P<0.05）,年度变化有统计学意义;农村组发病粗率为15.45/10万,中标率为11.74/10万,呈现出上升趋势（AAPC=10.58%,P<0.05）,年度变化有统计学意义。安徽省2010—2018年宫颈癌死亡粗率为4.01/10万,中标率为2.84/10万,呈现上升趋势（AAPC=9.06%,P<0.05）,有统计学意义;城市地区死亡粗率为4.13/10万,中标率为2.89/10万,呈现出上升趋势（AA...     

Postpartum Depression Among Rural Women From Developed and Developing Countries: A Systematic Review

Purpose: Postpartum depression (PPD) is a significant public health problem, with significant consequences for the mother, infant, and family. Available research has not adequately examined the potential impact of sociodemographic characteristics, such as place of residence, on risk for PPD. Therefore, this systematic review and meta‐analysis examines the prevalence of and risk factors for PPD in rural communities within developed and developing countries, and where possible, compares rates to those among urban women. Methods: Five databases were searched, from start dates through early May 2010, using key words relevant to PPD and rural residence. Peer‐reviewed articles were eligible if a standardized assessment of depression was administered to rural mothers within the first year postpartum. Data on PPD were extracted from 19 articles, of which 17 provided data for meta‐analyses. Findings: The overall prevalence of PPD among rural women was 27.0% (95% CI, 18.8%‐37.2%). Prevalence was somewhat higher among women in developing countries (31.3%; 95% CI, 21.3%‐43.5%) than among women in developed countries (21.5%; 95% CI, 10.9%‐38.0%), although there was significant heterogeneity among both groups of studies. Comparisons between rural and urban women yielded conflicting results. Although established PPD risk factors were associated with depression in rural women, additional risk factors were reported for rural women from developing countries, such as having 2 or more young children. Conclusions: Longitudinal studies with clearly defined “rural” and “comparison” groups are needed to determine whether rural residence is associated with increased risk for PPD. The results can inform prevention and treatment programs tailored to serve rural women.     

Prevalence and geographic distribution of cancer in the health area of Guadalajara

BACKGROUND: The total cancer prevalence falls within the range of 2%-3% of the population. Some data suggests differences in terms of whether the environment is urban or rural, other geographical factors and in the area surrounding nuclear power plants. This study is aimed at ascertaining said prevalences and the distribution thereof in the different geographical areas of the Guadalajara Healthcare District. METHODS: Point prevalence study in 1999 based on a systematic review of cases at primary and secondary sources in the Guadalajara Health District, including invasive malignant tumors among individuals over age 14. The overall and specific distribution in terms of the place of residence, region and proximity to nuclear power plants is analyzed, raw and adjusted prevalences/100,000 inhabitants and CI 95% prevalence index. RESULTS: A total of 2,717 cases were detected (raw prevalence: 2034.6/10(5)), there being a 50%-50% ratio between the urban and rural environments. The adjusted prevalence (worldwide population) is 1295.2/10(5), being greater in the urban environment (1479.9/10(5)) than in the rural environment (1136.3/10(5)). With regard to the geographic regions, solely thyroid cancer is more prevalent among women in the most depressed, mountainous areas, although involving a low-level casuistic. CONCLUSIONS: The cancer prevalences found are similar to those published and, following an age-based adjustment, are greater in the urban than in the rural environment. The differences among regions are related to the demographic and geographical characteristics and to the environment being urban.     

子宫颈癌筛查技术新进展

  目的  了解河北省不同地区农村妇女生殖系统健康情况及其分布特点。  方法  对2017年河北省12个地区及1个直管县共66个县市35～64岁已婚农村妇女370 129人进行妇科检查及细胞学检查,细胞学检查巴氏分级ⅡB级及以上者、TCT检查结果异常者行阴道镜检查,阴道镜检查结果怀疑宫颈病变的多点组织活检行病理学检查。  结果  实际筛查370 129人,宫颈癌筛查率为5.69 %;妇科筛查结果异常者86 767例,异常检出率为23.44 %,河北省农村妇女宫颈炎检出率为8.07 %,组织病理诊断宫颈上皮内瘤变733例（低级别病变352例;高级别病变381例）,宫颈浸润癌62例,检出率为0.17‰（62/370 129）,其他妇科恶性肿瘤0例。  结论  适龄妇女生殖健康状况严峻,定期开展宫颈癌筛查,准确检测和及时治疗宫颈上皮内瘤样变从而预防宫颈癌的发生,降低发病率及死亡率,有助于提高妇女健康水平。     

Pre-invasive cervical disease and uterine cervical cancer in Brazilian adolescents: prevalence and related factors

The objective was to describe the prevalence and factors associated with uterine cervical cancer (CA) and high-grade squamous intraepithelial lesions (HSIL) in adolescents. A cross-sectional study was carried out with 702 sexually active adolescents treated at a general hospital in Rio de Janeiro, Brazil, from 1993 to 2002. Screening was performed by cytopathology and colposcopy and confirmation by biopsy. Exposure variables were socio-demographic characteristics and those related to reproductive health, habits, and sexual behavior. Adjusted odds ratios were estimated using multivariate logistic regression analysis. Based on histopathology, the prevalence of HSIL/CA was 3% (95%CI: 1.8-4.6). There was one case of invasive cancer. With each additional pregnancy, the odds of HSIL/CA increased by 2.2 (95%CI: 1.1-4.4). Age was also associated with this outcome, doubling the odds of acquiring this degree of disease with each year of age (OR = 2.0; 95%CI: 1.2-3.4). The prevalence of lesions suggests the importance of including sexually active adolescent females in cervical cancer screening programs aimed at early detection and treatment of these lesions.     

2006-2017年中国女性乳腺癌和生殖系统癌症发病趋势分析

目的 评估2006-2017年不同年龄和地区女性乳腺癌和生殖系统癌症的发病趋势。方法 结合发病率、人口数计算全国分地区、分年龄的女性乳腺癌、外阴癌、阴道癌、宫颈癌、子宫体癌及卵巢癌的发病数及平均诊断年龄。通过世界标准人口进行标化。采用Joinpoint 4.5.0.1软件计算平均年变化百分比（AAPC）。结果 2006-2017年,6种癌症的合计年龄标化发病率（ASIR）从39.48/10万上升至51.11/10万（AAPC=2.24%,95%CI：1.59%~2.89%）。这一上升趋势在农村地区更加显著（AAPC=4.65%,95%CI：3.67%~5.64%）,而城市地区未见明显上升（AAPC=0.15%,95%CI：-0.26%~0.56%）。除子宫体癌外,其他5种癌症发病均呈上升趋势。宫颈癌的ASIR在城市和农村地区上升趋势相近。乳腺癌、阴道癌和外阴癌的ASIR在城市地区无明显上升趋势,而在农村地区明显上升。卵巢癌的ASIR在城市地区呈下降趋势,而在农村地区则呈上升趋势。从发病年龄上看,除子宫体癌外,所有女性癌症平均诊断年龄均呈上升趋势。通过世界标准人口标化后,仅在宫颈癌和阴道癌中观察到标化平均诊断年龄的上升,从49.11岁和55.15岁分别上升至52.13岁和58.81岁。结论 2006-2017年,女性癌症标化发病率总体呈上升趋势,且农村地区上升趋势高于城市地区。同时,农村居民的医疗资源可及性需进一步提升,保证医疗保健服务和早诊早治,从而弥合女性癌症城乡差距。     

2004-2005年广东省妇女乳腺癌和官颈癌患者死亡分析

目的 分析广东省第3次死因回顾性调查样本中妇女乳腺癌和宫颈癌患者死亡流行特征,为制定降低两癌死亡的策略提供科学依据.方法 收集广东省第3次死因回顾性抽样调查数据,采用描述性流行病学分析方法对乳腺癌、官颈癌死亡率、死亡构成等指标进行分析.结果 本次调查样本中女性7 457 302人,其中城市2 220 483人,农村5 ...     

24099例农村妇女宫颈癌和乳腺癌筛查结果分析

目的:掌握遂昌县农村妇女宫颈癌和乳腺癌(简称"两癌")的发病率,早期发现、早期治疗,降低"两癌"的治疗成本,提高患病妇女的生存率。方法:对2009年自愿参加"两癌"免费筛查的24 099例农村妇女的资料进行统计分析。结果:24 099例妇女中,宫颈细胞学异常578例,经组织活检确诊为宫颈癌18例,患病率为74.69/10万(18/24 099);宫颈上皮内瘤变(CIN)110例,患病率为456.45/10万(110/24 099);乳腺癌2例,患病率为8.3/10万(2/24 099)。宫颈癌多见于40～64岁妇女,乳腺癌多见于50～55岁妇女。结婚和生育年龄较早是宫颈癌的高危因素;文化程度低、保健意识不强、经济条件差的农村妇女是"两癌"的高发人群,也是重点干预对象。结论:农村妇女"两癌"发病率高,应加大农村防癌普查力度,希望政府能继续执行惠民政策,切实做到早预防、早发现和早治疗。     

Comparative analysis of invasive cervical cancer incidence rates in three Appalachian states

BACKGROUND: Invasive cervical cancer (ICC) rates remain elevated in the Appalachian region of the United States. We investigated patterns of invasive cervical cancer incidence rates in three Appalachian states (Kentucky, West Virginia, Pennsylvania) to uncover specific high-risk subgroups within this large and heterogeneous region. METHODS: The analysis was conducted for the three states combined and individually. Invasive cervical cancer rates were characterized by individual and county-level sociodemographic variables, including age, race, poverty, education, Appalachian status, and rural/urban status. Bivariate analyses and multivariable Poisson regression models were conducted to address the relative contributions of each variable to the risk of invasive cervical cancer. RESULTS: The three states differed in the contribution of each factor to the risk of invasive cervical cancer. The overall invasive cervical cancer incidence rates for Kentucky, West Virginia, and Pennsylvania were 13.4, 13.9, and 10.2 per 100,000/yr, respectively. After controlling for other demographic variables, the effect of Appalachian status on invasive cervical cancer was weaker, while rural status, education, and race were stronger, significant predictors. CONCLUSIONS: This study illustrates the heterogeneity of population demographics and invasive cervical cancer risk, and the need to identify subregions and subgroups within Appalachia at highest risk for this disease.     

Clinical and demographic predictors of late-stage cervical cancer

BACKGROUND: Despite increasingly widespread use of the Papanicolaou smear, almost half of all women with invasive cervical cancer are diagnosed at a late stage (regional or distant). Little is known about factors associated with late-stage diagnosis of cervical cancer. OBJECTIVE: To examine the relationship of age, race, education level, income level, smoking, marital status, health insurance type, comorbidity, and residence in an urban or rural setting to late stage at diagnosis of cervical cancer. METHODS: Incident cases of invasive cervical cancer occurring in 1994 in Florida were identified from the state tumor registry (N = 852). Cases were linked with state discharge abstracts and the 1990 US census. Multiple logistic regression was used to determine the relationship between predictor variables (age, race or ethnicity, marital status, smoking status, education level, income level, insurance type, comorbidity, and urban vs rural residence) and the odds of late-stage diagnosis. RESULTS: Age, marital status, and insurance type were associated with late-stage diagnosis. Each additional year of age was associated with a 3% increased odds of late-stage diagnosis (odds ratio [OR], 1.03; 95% confidence interval [CI], 1.02-1.05; P<.001). Being unmarried was associated with a 63% increased odds of late-stage diagnosis (OR, 1.63; 95% CI, 1.18-2.25; P=.003). Being uninsured was associated with a 60% increased odds of late-stage diagnosis (OR, 1.60; 95% CI, 1.07-2.38; P=.02). Having commercial health maintenance organization insurance was associated with a 46% decreased odds of late-stage disease (OR, 0.54; 95% CI, 0.30-0.96; P=.04). Race, education level, income level, smoking status, comorbidity, and urban residence were not associated with stage at diagnosis. CONCLUSIONS: Women with cervical cancer who are elderly, unmarried, and uninsured are more likely to be diagnosed at a late stage. These women should be targeted for cervical cancer education and screening programs.