ASPO Abstracts
Assessing the Role of Ethnicity and Nativity in Cervical Cancer Screening Disparities Among Women Living in the U.S.
Category: Cancer Health Disparities
Conference Year: 2023
Abstract Body:
Purpose of the study Studies have demonstrated higher cervical cancer incidence and lower cervical cancer screening rates in racial/ethnic minority women and among foreign-born (i.e., immigrant) women. This study aims to describe up-to-date cervical cancer screening status among subgroups defined by ethnicity and nativity. Methods Data from the National Health Interview Survey (NHIS) 2019 were analyzed. Included data were from n=9,394 women aged 21-65 years with no history of hysterectomy. Up-to-date cervical cancer screening status was based on the U.S. Preventive Services Task Force guidelines. Ethnicity was dichotomized as Hispanic versus non-Hispanic. Nativity was categorized as U.S- versus foreign-born based on country of birth. Weighted descriptive statistics and log-linked binomial regression were conducted to assess cervical cancer screening adherence by ethnicity-nativity and other sociodemographic variables (age, education, health insurance, and marital status). Statistical significance was assessed at p<0.05. Results The sample was 10.0% foreign-born Hispanic (FBH), 9.0% U.S.-born Hispanic (USBH), 11.4% foreign-born non-Hispanic (FBNH), and 69.6% U.S.-born non- Hispanic (USBNH). The overall up-to-date screening prevalence was 75.4% with USBNH being most up-to-date (78.4%) followed by USBH women (73.1%), FBNH women (69.8%), and FBH women (65.7%; p<0.0001). In unadjusted models, all ethnicity-nativity subgroups had significantly lower prevalence of up-to- date screening when compared to USBNH women. However, after adjusting for sociodemographic variables, USBH women no longer had a statistically significant difference in screening prevalence while both foreign-born subgroups maintained significantly lower prevalence of screening compared to USBNH women [aPR FBH: 0.93 (95% CI 0.88-0.99) and aPR FBNH: 0.87 (95% CI 0.83-0.90)]. Conclusions Foreign-born women, regardless of ethnicity, have lower prevalence of up-to-date cervical cancer screening after adjusting for sociodemographic factors. Targeted interventions are needed to increase cervical cancer screening participation among foreign-born women.
Keywords: cervical cancer screening, disparities, nativity, ethnicity