Cervical cancer is major cause of morbidity and mortality in South Asian countries, including India and Pakistan. In the United States, South Asians are one of the fastest-growing major ethnic groups. However, the clinical characteristics and outcomes of cervical cancer among Asian Indian and Pakistani Americans (AIPA) in the United States are not defined.


Disease characteristics, treatment, and survival information between 2000 and 2018 for AIPA and non-Hispanic White (NHW) cases diagnosed after age 18 were obtained from the SEER database. Baseline characteristics were compared using descriptive analysis. Univariate survival analysis was done using Kaplan-Meier plot with log-rank test, and Cox proportional hazard regression model was used for multivariate survival analysis.


A total of 32,153 cases of cervical cancer were included, among which 31,841 were NHWs and 312 were AIPAs. Of the AIPAs, 180(57.7%) were Indians, 115(36.9%) were Pakistanis and 17(5.4%) were Indian/Pakistani not otherwise specified. AIPA women were significantly older at diagnosis than NHW women (mean age at diagnosis: 56.9 vs. 50.5 years; p<.001). AIPA were significantly more likely than NHW to be diagnosed with regional or distant disease (p=0.002), more likely to receive chemotherapy (55.7% vs. 46.5%; p=0.001), less likely to receive surgery (50.3% vs. 59.2%; p=0.007), and more likely to receive radiation (58.3% vs. 52.5%; p=0.04). The overall survival between AIPA and NHW did not differ significantly in the univariate analysis(p=0.26); however, when adjusting for age and other covariates, the Cox model demonstrated that AIPA had better overall survival than NHW (HR=0.62, CI=0.50-0.77).


Although AIPA had better overall survival after adjustment for covariates, the older age and higher stage at diagnosis, compared to NHW, may indicate a disparity in access to screening. The unique characteristics of cervical cancer in AIPA women need to be studied further.