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#Grand Rounds

What Factors Predict Cervical Cancer Screening in Women Between 45 and 65 Years of Age?

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BACKGROUND AND PURPOSE:

  • Harper et al. (Preventive Medicine, 2019) used data from large, nationwide health surveys to determine predictors of cervical cancer screening in older women

METHODS:

  • Analysis of three US-based, nationwide health surveys
    • The Behavioral Risk Factor Surveillance System (BRFSS 2016)
    • The Health Information National Trends Survey (HINTS 2017)
    • The Health Center Patient Survey (HCPS 2014)
  • Participants
    • Women without hysterectomy
    • 45 to 65 years of age
  • Data analysis
    • Analyzed survey data using univariate and multivariate analyses
  • Primary outcome
    • Cytology within the last 3  years

RESULTS:

  • Data from approximately 44,000 women were included in the analyses
  • Overall cervical cancer screening rates were
    • BRFSS: 71% among 41,657 women
    • HINTS: 79% among 740 women
    • HCPS: 66% among 1571 women
  • Women in the following demographic categories were less likely to report cervical cancer screening
    • 60 to 64  years old vs 45 to 49 years
      • Adjusted prevalence ratios (aPR)  0.88 (95% CI, 0.85 to 0.91)
    • Women in rural locations vs urban areas
      • aPR  0.95 (95% CI: 0.92 to 0.98)
  • Women in the following demographic categories were more likely to report cervical cancer screening
    • Women with more vs less than high school education
      • aPR  1.20 (95% CI, 1.13 to 1.28)
    • Women with insurance vs uninsured women
      • aPR  1.47 (95% CI, 1.33 to 1.62)
  • The above data was derived from BRFSS but the trends were similar in the HINTS and HCPS databases
  • Predictions based on race and ethnicity varied between surveys

CONCLUSION:

  • All three studies showed that reported screening rates “are insufficient to reduce cervical cancer incidence”
  • The strongest predictor of cervical cancer screening in women ages 45 to 65 was insurance coverage
    • Women of younger age and in urban locations were also more likely to report screening

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Learn More – Primary Sources:

Three large scale surveys highlight the complexity of cervical cancer under-screening among women 45–65 years of age in the United States

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Related ObG Topics:

Managing Abnormal Cervical Cytology in the Postmenopausal Patient
What is the Most Efficient Method for Cervical Cancer Screening?
The HPV Vaccine Leads to a Reduction in Cervical Precancers in Young Women in the U.S.
Practical info for your gynecology practice
Screening for Cervical Cancer in the Woman at Average Risk

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