Treating cervical cancer: Breast and Cervical Cancer Prevention and Treatment Act patients

Objective: To investigate cervical cancer treatment of patients enrolled under the Breast and Cervical Cancer Prevention and Treatment Act in Georgia. Study Design: Georgia Comprehensive Cancer Registry and Medicaid enrollment/claims were used to identify enrollees with preinvasive disease (n = 1149) and invasive cervical cancer (n = 444). Logistic regressions were used to estimate factors associated with the odds of receiving: (1) cancer workup, (2) precancerous procedure, (3) surgery, (4) radiation, and (5) chemotherapy. Results: Preinvasive disease cases with cervical intraepithelial neoplasia 3, in situ, a comorbidity or without a Commission on Cancer approved hospital nearby were more likely to receive surgery. Among invasive cases, later stage was associated with higher odds of receiving radiation or chemotherapy. Black patients were less likely to have surgery than white patients regardless of preinvasive (P <.01) or invasive status (P = .05). Conclusion: Treatment patterns among Georgia Medicaid cases appear appropriate to stage but 18% with invasive cervical cancer received no cancer treatment, although Medicaid enrolled.