ASPO Abstracts
Prevalence and Determinants of cervical cancer screening using co-testing with cervical cytology and HPV testing among eligible women in Texas
Category: Cancer Health Disparities
Conference Year: 2019
Abstract Body:
Background: In the US and Texas, recommended options for cervical cancer screening in women aged ≥ 30 years include cervical cytology alone or a combination of cytology and HPV testing (co-testing). While there is a body of evidence suggesting that co-testing may be a preferable screening option in this group of women, little is known about the characteristics of women who benefit from screening with co-testing. In this population based study, we describe differences between women screened by co-testing versus cytology alone, and examine socio-demographic characteristics, personal and family medical history, mental and physical health, and perceived risk of cancer as potential determinants for cervical screening uptake with co-testing in Texas.Methods: Between February and March of 2018, a cross-sectional multistage area probability design-based survey was administered to a representative sample of Texas residents. Of the 1,348 female respondents, 572 women aged 30 years or above were included in this analysis. Population-weighted percentages were used to compare characteristics between groups, and weighted survey logistic regression was used to identify determinants of screening uptake with co-testing. Results: In this population, 273 (44.8%) and 242 (45.5%) women reported being screened by co-testing and cervical cytology alone, respectively. Women in the co-testing group were younger (mean age: 48.4 vs 51.7 years), more often Hispanics (33.9% vs 24.0%), living more frequently in urban areas (52.1% vs 45.2%), using more frequently hormonal contraception (83.9% vs 75.4%), more frequently immunized against Hepatitis B virus (56.7% vs 28.9%) and Human Papillomavirus (13.0% vs 1.5%), more frequently having an annual income ≥ $75,000 (32.1% vs 21.6%), than women in the cervical cytology group. In the multivariable analysis, women with a younger age (OR: 0.93, 95% CI: 0.91-0.95), lower income (OR: 0.49 (0.25-0.95)), personal history of any cancer (OR: 3.59 (1.53-8.41)), and history of HBV vaccination (OR: 2.41 (1.48-3.92)) were more likely to be screened with co-testing than to be screened with cervical cytology alone. Conclusion: Among women who have ever attended cervical screening in Texas, certain groups are more likely to get screened with co-testing.
Keywords: : Cervical cancer screening, cytology, HPV testing, co-testing, determinants, Texas