RT Journal Article SR Electronic T1 Cervical Cancer Incidence in Ontario Women: Differing Sociodemographic Gradients by Morphologic Type (Adenocarcinoma Versus Squamous Cell) JF International Journal of Gynecologic Cancer JO Int J Gynecol Cancer FD BMJ Publishing Group Ltd SP 1341 OP 1346 DO 10.1097/IGC.0000000000000217 VO 24 IS 7 A1 Maegan V. Prummel A1 Stephanie W. Young A1 Elisa Candido A1 Diane Nishri A1 Laurie Elit A1 Loraine D. Marrett YR 2014 UL http://ijgc.bmj.com/content/24/7/1341.abstract AB Objective Identify patterns in cervical cancer incidence in Ontario according to neighborhood sociodemographic characteristics over time and by morphologic type.Methods Incident cases of cervical cancer diagnosed from 1991 to 2009 were obtained from the Ontario Cancer Registry. Population data and data on neighborhood sociodemographic characteristics were obtained from the Canadian Census. Age-standardized incidence rates (ASIR) and rate ratios (RRs) with 95% confidence intervals (CIs) were calculated for each sociodemographic characteristic, stratified by morphologic type (squamous cell carcinoma and adenocarcinoma) and time period of diagnosis.Results Incidence was 51% higher in the poorest neighborhoods compared with the richest (RR, 1.51; 95% CI, 1.42–1.61) and 7% higher in rural areas compared with urban (RR, 1.07; 95% CI, 1.01–1.13). Incidence of squamous cell carcinoma was significantly higher in the poorest neighborhoods compared with the richest (RR, 1.74; 95% CI, 1.61–1.88), a trend observed for all time periods, and in rural areas compared with urban (RR, 1.10; 95% CI, 1.02–1.18). For adenocarcinoma, ASIRs in the earlier time period (1991–1998) were higher in the poorest neighborhoods compared with richest (RR, 1.26; 95% CI, 1.01–1.57), whereas for the more recent time period (1999–2009), ASIRs were lower for women living in the poorest neighborhoods compared with the richest (RR, 0.82; 95% CI, 0.68–0.99).Conclusions This study identified significantly higher incidence of cervical cancer in low-income neighborhoods in Ontario. The association was especially pronounced for squamous cell carcinoma and varied by time period for adenocarcinoma. Improvements to screening and prevention efforts against oncogenic human papillomavirus strains would increase the detection of cervical cancer, adenocarcinoma especially, and may further reduce cervical cancer incidence.