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
Affiliations
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
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
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
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.
