Using Geospatial Analysis to Identify Priority Communities for Cervical Cancer Prevention in Texas

IntroductionCervical cancer (CC) is almost entirely preventable, yet it is the fourth most frequently diagnosed cancer among women worldwide. CC incidence suggests missed opportunities for prevention. Geospatial analysis could strategically guide public health interventions. This study aimed to identify geographic clusters of CC incidence in Texas, a state with a higher than national rate of CC incidence and mortality.MethodsIn this population-based cross-sectional study, we analyzed incident CC data among Texas women aged 30-64 years, from 2014 to 2018. We conducted a purely spatial Poisson-based analysis function in SaTScan to examine geographic clusters of higher-than-expected proportions of CC incidence (i.e., hot spots) and adjusted for age.ResultsA total of 5060 women aged 30-64 years with incident CC diagnosis (mean age: 45.7 years, SD=9.6), including 1840 (36.4%) Hispanic, 591 (11.7%) non-Hispanic Black, 2397 (47.4%) non-Hispanic White, and 232 (4.6%) other races were analyzed. Spatial scan analysis detected 7 significant hot spots of CC incidence. Hot spots were identified in the South Texas Plains (near Mexico border), Gulf Coast (Houston), Prairies and Lakes (North Texas), Panhandle Plains (Northwest Texas), and Piney Woods (Southeast Texas) regions of Texas. Hot spots, compared to the rest of Texas, had higher proportions of Hispanic population and individuals with socioeconomic disadvantage.ConclusionsWe found spatial variation in CC incidence in Texas. The hot spot areas can benefit from targeted, novel, scalable, and cost-effective interventions to increase HPV vaccination and screening, and early detection and treatment of precancerous cervical lesions.