Cervical cancer, a disease of poverty:: Mortality differences between urban and rural areas in Mexico

Objective. To examine cervical cancer mortality rates in Mexican urban and rural communities, and their association with poverty-related factors,during 1990-2000. Material and Methods:We analyzed data from national databases to obtain mortality trends and regional variations using a Poisson regression model based on location (urban-rural). Results. During 1990-2000 a total of 48 761 cervical cancer (CC) deaths were reported in Mexico (1990=4 280 deaths/year; 2000=4 620 deaths/year). On average, 12 women died every 24 hours, with 0.76% yearly annual growth in CC deaths. Women living in rural areas had 3.07 higher CC mortality risks compared to women with urban residence. Comparison of state CC mortality rates (reference=Mexico City) found higher risk in states with lower socio-economic development (Chiapas, relative risk [RR]=10.99;Nayarit, RR=10.5). Predominantly rural states had higher CC mortality rates compared to Mexico City (lowest rural population). Conclusions. CC mortality is associated with poverty-related factors, including lack of formal education, unemployment, low socioeconomic level, rural residence and insufficient access to healthcare. This indicates the need for eradication of regional differences in cancer detection.