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Community-level Social Vulnerability and Cervical Cancer Mortality Among Young and Old Adults in the State of Alabama.

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Title: Community-level Social Vulnerability and Cervical Cancer Mortality Among Young and Old Adults in the State of Alabama.
Authors: Patel, Pranali G.1, Chowdhury, Sabrina1, Wiener, Howard W.1, George, Justin T.2, Abdalla, Ehsan3, Ye, Yuanfan4, Boitano, Teresa K. L.4, Sudenga, Staci L.5, Oates, Gabriela R.6, Shrestha, Sadeep1,7 sshrestha@uab.edu
Source: Journal of Community Health. Oct2025, Vol. 50 Issue 5, p985-992. 8p.
Subject Terms: *Retrospective studies, *Longitudinal method, *Adults, Cervix uteri tumors, Independent living, Research funding, Descriptive statistics, Kaplan-Meier estimator, Marital status, Data analysis software, Psychological vulnerability, Overall survival, Proportional hazards models, Middle age
Geographic Terms: Alabama
Abstract: In addition to individual factors, differences in community-level factors impact mortality rates of cervical cancer (CC), especially in the Southeast United States, where CC one-year mortality is significantly higher than national average. This study investigated the association between community-level social vulnerability measured using the Centers for Disease Control and Prevention's Social Vulnerability Index (SVI) and overall and one-year CC mortality in Alabama. Retrospective cohort study using Alabama State Cancer Registry data from 2012 to 2021. Outcome of interest was mortality due to CC. Residential addresses were geocoded to determine SVI scores categorized into quartiles. Cox proportional hazards model was used to assess associations between SVI quartiles and overall and one-year CC mortality adjusting for age at diagnosis, race, marital status, and insurance status. Further, CC mortality in younger adults (≤50 years) was compared with older adults (> 50 years). A total of 1,325 women with CC were included in the study. The median age at diagnosis was 49 years (IQR: 39–62) and 69.73% were White. Median follow-up time was 9 months (IQR: 5–17). Among older adults, we observed statistically significant association between higher SVI quartiles and overall mortality (Q4: aHR 1.86; 95% CI 1.15, 3.01; p = 0.012] and one-year mortality (Q3: aHR 2.66; 95% CI 1.34, 5.29; p = 0.005; Q4: aHR 2.45; 95% CI 1.18, 5.08; p = 0.016). This study highlights the role of community factors in CC mortality among older women. Community-level strategies are needed to reduce the burden of CC mortality in Alabama and other high-risk regions. [ABSTRACT FROM AUTHOR]
Copyright of Journal of Community Health is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
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  Data: Community-level Social Vulnerability and Cervical Cancer Mortality Among Young and Old Adults in the State of Alabama.
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  Data: <searchLink fieldCode="AR" term="%22Patel%2C+Pranali+G%2E%22">Patel, Pranali G.</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Chowdhury%2C+Sabrina%22">Chowdhury, Sabrina</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Wiener%2C+Howard+W%2E%22">Wiener, Howard W.</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22George%2C+Justin+T%2E%22">George, Justin T.</searchLink><relatesTo>2</relatesTo><br /><searchLink fieldCode="AR" term="%22Abdalla%2C+Ehsan%22">Abdalla, Ehsan</searchLink><relatesTo>3</relatesTo><br /><searchLink fieldCode="AR" term="%22Ye%2C+Yuanfan%22">Ye, Yuanfan</searchLink><relatesTo>4</relatesTo><br /><searchLink fieldCode="AR" term="%22Boitano%2C+Teresa+K%2E+L%2E%22">Boitano, Teresa K. L.</searchLink><relatesTo>4</relatesTo><br /><searchLink fieldCode="AR" term="%22Sudenga%2C+Staci+L%2E%22">Sudenga, Staci L.</searchLink><relatesTo>5</relatesTo><br /><searchLink fieldCode="AR" term="%22Oates%2C+Gabriela+R%2E%22">Oates, Gabriela R.</searchLink><relatesTo>6</relatesTo><br /><searchLink fieldCode="AR" term="%22Shrestha%2C+Sadeep%22">Shrestha, Sadeep</searchLink><relatesTo>1,7</relatesTo><i> sshrestha@uab.edu</i>
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  Data: <searchLink fieldCode="JN" term="%22Journal+of+Community+Health%22">Journal of Community Health</searchLink>. Oct2025, Vol. 50 Issue 5, p985-992. 8p.
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  Data: *<searchLink fieldCode="DE" term="%22Retrospective+studies%22">Retrospective studies</searchLink><br />*<searchLink fieldCode="DE" term="%22Longitudinal+method%22">Longitudinal method</searchLink><br />*<searchLink fieldCode="DE" term="%22Adults%22">Adults</searchLink><br /><searchLink fieldCode="DE" term="%22Cervix+uteri+tumors%22">Cervix uteri tumors</searchLink><br /><searchLink fieldCode="DE" term="%22Independent+living%22">Independent living</searchLink><br /><searchLink fieldCode="DE" term="%22Research+funding%22">Research funding</searchLink><br /><searchLink fieldCode="DE" term="%22Descriptive+statistics%22">Descriptive statistics</searchLink><br /><searchLink fieldCode="DE" term="%22Kaplan-Meier+estimator%22">Kaplan-Meier estimator</searchLink><br /><searchLink fieldCode="DE" term="%22Marital+status%22">Marital status</searchLink><br /><searchLink fieldCode="DE" term="%22Data+analysis+software%22">Data analysis software</searchLink><br /><searchLink fieldCode="DE" term="%22Psychological+vulnerability%22">Psychological vulnerability</searchLink><br /><searchLink fieldCode="DE" term="%22Overall+survival%22">Overall survival</searchLink><br /><searchLink fieldCode="DE" term="%22Proportional+hazards+models%22">Proportional hazards models</searchLink><br /><searchLink fieldCode="DE" term="%22Middle+age%22">Middle age</searchLink>
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  Label: Geographic Terms
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  Data: <searchLink fieldCode="DE" term="%22Alabama%22">Alabama</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: In addition to individual factors, differences in community-level factors impact mortality rates of cervical cancer (CC), especially in the Southeast United States, where CC one-year mortality is significantly higher than national average. This study investigated the association between community-level social vulnerability measured using the Centers for Disease Control and Prevention's Social Vulnerability Index (SVI) and overall and one-year CC mortality in Alabama. Retrospective cohort study using Alabama State Cancer Registry data from 2012 to 2021. Outcome of interest was mortality due to CC. Residential addresses were geocoded to determine SVI scores categorized into quartiles. Cox proportional hazards model was used to assess associations between SVI quartiles and overall and one-year CC mortality adjusting for age at diagnosis, race, marital status, and insurance status. Further, CC mortality in younger adults (≤50 years) was compared with older adults (> 50 years). A total of 1,325 women with CC were included in the study. The median age at diagnosis was 49 years (IQR: 39–62) and 69.73% were White. Median follow-up time was 9 months (IQR: 5–17). Among older adults, we observed statistically significant association between higher SVI quartiles and overall mortality (Q4: aHR 1.86; 95% CI 1.15, 3.01; p = 0.012] and one-year mortality (Q3: aHR 2.66; 95% CI 1.34, 5.29; p = 0.005; Q4: aHR 2.45; 95% CI 1.18, 5.08; p = 0.016). This study highlights the role of community factors in CC mortality among older women. Community-level strategies are needed to reduce the burden of CC mortality in Alabama and other high-risk regions. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Journal of Community Health is the property of Springer Nature and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
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      – Type: doi
        Value: 10.1007/s10900-025-01482-6
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      – Code: eng
        Text: English
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        PageCount: 8
        StartPage: 985
    Subjects:
      – SubjectFull: Retrospective studies
        Type: general
      – SubjectFull: Longitudinal method
        Type: general
      – SubjectFull: Adults
        Type: general
      – SubjectFull: Cervix uteri tumors
        Type: general
      – SubjectFull: Independent living
        Type: general
      – SubjectFull: Research funding
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      – SubjectFull: Descriptive statistics
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      – SubjectFull: Kaplan-Meier estimator
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      – SubjectFull: Marital status
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      – SubjectFull: Data analysis software
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      – SubjectFull: Psychological vulnerability
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      – SubjectFull: Overall survival
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      – SubjectFull: Proportional hazards models
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      – SubjectFull: Middle age
        Type: general
      – SubjectFull: Alabama
        Type: general
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      – TitleFull: Community-level Social Vulnerability and Cervical Cancer Mortality Among Young and Old Adults in the State of Alabama.
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              Text: Oct2025
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