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Relative risk of cervical cancer in indigenous women in Australia, Canada, New Zealand, and the United States: A systematic review and meta-analysis

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Abstract

We performed a systematic review and meta-analysis of cervical cancer risk in indigenous women in Australia, Canada, New Zealand, and the United States, in order to identify whether risks of cervical dysplasia, cervical cancer, and cervical cancer-related mortality are higher in indigenous relative to non-indigenous populations. We identified 35 studies published in 1969–2008. In our findings, indigenous populations did not have an elevated risk of cervical dysplasia or carcinoma in situ relative to non-indigenous populations, but had elevated risks of invasive cervical cancer (pooled RR=1.72) and cervical cancer-related mortality (pooled RR=3.45). There was a log-linear relationship between relative risk and disease stage. In conclusion, the indigenous women have a markedly higher risk of cervical cancer morbidity and mortality than non-indigenous women, but no increased risk of early-stage disease, suggesting that structural, social, or individual barriers to screening, rather than baseline risk factors, are influencing poor health outcomes.

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Authors and Affiliations

  1. Faculty of Medicine, Dalla Lana School of Public Health, University of Toronto, 155 College Street, 6th floor, Ontario, M5 T 3M7, Toronto, Canada

    Marija Vasilevska, Stephanie A Ross, Dionne Gesink & David N Fisman

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  1. Marija Vasilevska
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  2. Stephanie A Ross
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  3. Dionne Gesink
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  4. David N Fisman
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Correspondence to David N Fisman.

Additional information

Lack of increased risk of early-stage cervical cancer suggests that structural, social, or individual barriers to screening, rather than baseline risk factors, influence increased mortality in indigenous populations.

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Vasilevska, M., Ross, S., Gesink, D. et al. Relative risk of cervical cancer in indigenous women in Australia, Canada, New Zealand, and the United States: A systematic review and meta-analysis. J Public Health Pol 33, 148–164 (2012). https://doi.org/10.1057/jphp.2012.8

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