Trends and Racial/Ethnic Differences in Predictors of Cervical Cancer Screening among US Women Ages 30-64 Years

Authors

Itunu O Sokale
Jane R Montealegre
Abiodun O Oluyomi
Aaron P Thrift

Publication Date

1-9-2023

Journal

Cancer Epidemiology, Biomarkers & Prevention

DOI

10.1158/1055-9965.EPI-22-0970

PMID

36306382

PMCID

PMC9839647

PubMedCentral® Posted Date

7-9-2023

PubMedCentral® Full Text Version

Author MSS

Published Open-Access

yes

Keywords

United States, Humans, Female, Aged, Adult, Middle Aged, Uterine Cervical Neoplasms, Early Detection of Cancer, Ethnicity, Social Class, Hysterectomy, Cervical cancer screening, Pap testing, HPV testing, race/ethnicity

Abstract

BACKGROUND: Cervical cancer screening (CCS) participation has decreased in the United States over the last several decades, contributing to cervical cancer's sustained incidence and mortality. This study examined recent trends and racial/ethnic differences in predictors of CCS uptake among US women.

METHODS: We analyzed combined data from the 2016 to 2020 Behavioral Risk Factor Surveillance System (BRFSS) and included 235,713 women ages 30 to 64 years without a hysterectomy. We used simple linear regression to assess trends over time and multivariable logistic regression models to evaluate racial/ethnic differences in predictors of up-to-date CCS.

RESULTS: We found little change in CCS over the 5-year interval and screening rates disparities among racial minority women. The overall population showed stable CCS completion rates from 2016 to 2018 (84.2% vs. 84.6%), and then a small dip from 2018 to 2020 (from 84.6% to 83.3%). Despite a slight decline in 2020, HPV-based testing increased significantly among all subgroups and overall, from 2016 to 2020 (from 43.4% to 52.7%). Multivariable regression models showed racial/ethnic differences in predictors of CCS. Across all racial/ethnic subgroups, older women were less likely to receive timely screening. Women who had routine check-ups had higher odds of being up to date. However, the link between CCS and socioeconomic status varied.

CONCLUSIONS: Age and racial/ethnic disparities persist in CCS, and predictors of screening vary. Notwithstanding, routine health examinations was positively associated with screening regardless of race/ethnicity.

IMPACT: Our analyses suggest that leveraging primary care to optimize CCS uptake may reduce gaps in screening.

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