美国的宫颈癌负担存在明显差异，特别是在种族、民族和地域方面。晚期诊断是筛查获取和利用不足的一个指标。旨在确定德克萨斯州诊断时晚期宫颈癌的地理空间集群。这项基于人群的横断面研究使用了来自德克萨斯州癌症中心的宫颈癌事件数据2014年至2018年18岁或以上女性患者的登记。使用诊断时的居住坐标（纬度和经度）对晚期宫颈癌病例在人口普查区级别进行地理编码 (n = 5265)。统计分析于 2023 年 4 月至 9 月进行。诊断时居住的人口普查区。晚期宫颈癌诊断（即按美国国家癌症研究所监测、流行病学和最终结果总结阶段 2 至 4 [区域传播] 或 7 分类的病例） [远处转移]）。基于泊松概率的 SaTScan 纯空间扫描统计模型应用于人口普查区级别，以识别比晚期宫颈癌诊断预期更高（热点）或更低（冷点）比例的地理集群，并根据在总共 6484 名宫颈癌女性患者中（平均 [SD] 年龄，48.7 [14.7] 岁），2300 名 (35.5%) 为西班牙裔，798 名 (12.3%) 为非西班牙裔黑人，3090 名 (47.6) 名非西班牙裔黑人。 %）是非西班牙裔白人，296 人（4.6%）是其他种族或民族。在 6484 名患者中，分析了 2892 名晚期诊断患者（平均 [SD] 年龄，51.8 [14.4] 岁）。在晚期诊断患者中，1069 名 (37.0%) 为西班牙裔，417 名 (14.4%) 为非西班牙裔。西班牙裔黑人、1307 名 (45.2%) 为非西班牙裔白人，99 名 (3.4%) 为其他种族或族裔。SaTScan 空间分析确定了德克萨斯州晚期宫颈癌诊断的 7 个具有统计显着性的聚类，其中 4 个为热点热点地区包括 1128 个人口普查区，主要分布在德克萨斯州南部平原、墨西哥湾沿岸以及草原和湖泊地区（德克萨斯州北部）。在 2892 名晚期宫颈癌患者中，880 名（30.4%）是晚期宫颈癌患者。在人口普查区域层面对集群特征进行比较表明，热点地区与冷点和德克萨斯州其他地区在种族和民族比例、非美国出生人口以及社会经济地位方面存在显着差异。在检查晚期宫颈癌诊断的地理空间集群的截面研究中，发现德克萨斯州晚期宫颈癌诊断存在地域差异。这些发现表明这些社区可能受益于积极的宫颈癌干预措施。

There are stark disparities in cervical cancer burden in the United States, notably by race and ethnicity and geography. Late-stage diagnosis is an indicator of inadequate access to and utilization of screening.To identify geospatial clusters of late-stage cervical cancer at time of diagnosis in Texas.This population-based cross-sectional study used incident cervical cancer data from the Texas Cancer Registry from 2014 to 2018 of female patients aged 18 years or older. Late-stage cervical cancer cases were geocoded at the census tract level (n = 5265) using their residential coordinates (latitude and longitude) at the time of diagnosis. Statistical analysis was performed from April to September 2023.Census tract of residence at diagnosis.Late-stage cervical cancer diagnosis (ie, cases classified by the National Cancer Institute Surveillance, Epidemiology and End Results summary stages 2 to 4 [regional spread] or 7 [distant metastasis]). A Poisson probability-based model of the SaTScan purely spatial scan statistics was applied at the census tract-level to identify geographic clusters of higher (hot spots) or lower (cold spots) proportions than expected of late-stage cervical cancer diagnosis and adjusted for age.Among a total of 6484 female patients with incident cervical cancer cases (mean [SD] age, 48.7 [14.7] years), 2300 (35.5%) were Hispanic, 798 (12.3%) were non-Hispanic Black, 3090 (47.6%) were non-Hispanic White, and 296 (4.6%) were other race or ethnicity. Of the 6484 patients, 2892 with late-stage diagnosis (mean [SD] age, 51.8 [14.4] years were analyzed. Among patients with late-stage diagnosis, 1069 (37.0%) were Hispanic, 417 (14.4%) were non-Hispanic Black, 1307 (45.2%) were non-Hispanic White, and 99 (3.4%) were other race or ethnicity. SaTScan spatial analysis identified 7 statistically significant clusters of late-stage cervical cancer diagnosis in Texas, of which 4 were hot spots and 3 were cold spots. Hot spots included 1128 census tracts, predominantly in the South Texas Plains, Gulf Coast, and Prairies and Lakes (North Texas) regions. Of the 2892 patients with late-stage cervical cancer, 880 (30.4%) were observed within hot spots. Census tract-level comparison of characteristics of clusters suggested that hot spots differed significantly from cold spots and the rest of Texas by proportions of racial and ethnic groups, non-US born persons, and socioeconomic status.In this cross-sectional study examining geospatial clusters of late-stage cervical cancer diagnosis, place-based disparities were found in late-stage cervical cancer diagnosis in Texas. These findings suggest that these communities may benefit from aggressive cervical cancer interventions.