Failure to deliver guideline-concordant treatment may contribute to disparities among Hispanic/Latinx cervical cancer patients. This study investigated the association between survival rates in Hispanic/Latinx subpopulations and the provision of guideline-concordant care. We analyzed patients with primary cervical cancer from 2004 to 2019 (National Cancer Database). We developed nine quality metrics based on FIGO staging (2009). Clinical and demographic covariates were analyzed using Chi-squared tests. Adjusted associations between receipt of guideline-concordant care and races and ethnicities were analyzed using multivariable marginal Poisson regression models. Adjusted Cox proportional hazard models were utilized to evaluate survival probability. A total of 95,589 patients were included. Hispanic/Latinx and Non-Hispanic Black (NHB) populations were less likely to receive guideline-concordant care in four and five out of nine quality metrics, respectively. Nonetheless, the Hispanic/Latinx group exhibited better survival outcomes in seven of nine quality metrics. Compared to Mexican patients, Cuban patients were 1.17 times as likely to receive timely initiation of treatment in early-stage disease (RR 1.17, 95% CI 1.04–1.37, < 0.001). Puerto Rican and Dominican patients were, respectively, 1.16 (RR 1.16, 95% CI 1.07–1.27, p < 0.001) and 1.19 (RR 1.19, 95% 1.04–1.37, > 0.01) times as likely to undergo timely initiation of treatment in early-stage disease. Patients of South or Central American (RR 1.18, 95% CI 1.10–1.27, < 0.001) origin were more likely to undergo timely initiation of treatment in locally advanced disease. Significant differences in survival were identified among our cohort despite the receipt of guideline concordant care, with notably higher survival among Hispanic/Latinx populations.

中文翻译：

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西班牙裔/拉丁裔宫颈癌亚群的生存率与指南一致护理的差异相关

未能提供符合指南的治疗可能会导致西班牙裔/拉丁裔宫颈癌患者之间的差异。这项研究调查了西班牙裔/拉丁裔亚群的生存率与提供符合指南的护理之间的关系。我们分析了 2004 年至 2019 年原发性宫颈癌患者（国家癌症数据库）。我们根据FIGO 分期（2009 年）制定了九个质量指标。使用卡方检验分析临床和人口统计协变量。使用多变量边际泊松回归模型分析了接受指南一致护理与种族和民族之间调整后的关联。调整后的 Cox 比例风险模型用于评估生存概率。总共纳入了 95,589 名患者。西班牙裔/拉丁裔和非西班牙裔黑人 (NHB) 人群在九个质量指标中分别有四项和五项获得符合指南的护理的可能性较小。尽管如此，西班牙裔/拉丁裔群体在九个质量指标中的七个中表现出更好的生存结果。与墨西哥患者相比，古巴患者在早期疾病中及时开始治疗的可能性是墨西哥患者的 1.17 倍（RR 1.17，95% CI 1.04–1.37，< 0.001）。波多黎各和多米尼加患者及时开始治疗的可能性分别是 1.16（RR 1.16，95% CI 1.07-1.27，p < 0.001）和 1.19（RR 1.19，95% 1.04-1.37，> 0.01）倍。早期疾病。来自南美洲或中美洲（RR 1.18，95% CI 1.10-1.27，< 0.001）的患者更有可能在局部晚期疾病中及时开始治疗。尽管接受了指南一致的护理，但我们的队列中的生存率仍存在显着差异，西班牙裔/拉丁裔人群的生存率明显更高。