Factors associated with cervical cancer screening in a safety net population

Abstract

AIMTo identify factors associated with Papanicolaou-smear (Pap-smear) cervical cancer screening rates in a safety net population.METHODSFrom January 2012 to May 2013, the use of Pap-smear was determined for all patients seen at the breast clinic in a safety net hospital. Health literacy assessment was performed using the validated Newest Vital Sign. The records of patients were reviewed to determine if they had undergone Pap-smears for cervical cancer screening. Sociodemographic information was collected included age, education, monthly income, race/ethnicity, employment, insurance status, and primary care provider of the patient. Logistic regression analysis was then performed to determine factors associated with utilization of Pap-smears. Crude and adjusted odds ratios derived from multivariate logistic regression models were calculated as well as the associated 95%CIs and P-values.RESULTSOverall, 39% had Pap-smears in the prior 15 mo, 1377 consecutive women were seen during the study period and their records were reviewed. Significantly more patients with adequate health literacy underwent Pap-smears as compared to those with limited health literacy (59% vs 34%, P < 0.0001). In multivariate analysis, patients with adequate health literacy, younger patients, and those with later age of first live birth were more likely to undergo Pap-smears. Patients whose primary care providers were gynecologists were also significantly more likely to have Pap-smears compared to other specialties (P < 0.0001). Patients younger than 21 years or older than 65 years underwent screening less frequently (11% and 11%, respectively) than those 21-64 years (41%, P < 0.0001). Race, ethnicity, language, and insurance status were not associated with Pap-smear screening rates.CONCLUSIONPatient health literacy and primary care physician were associated with Pap-smear utilization. Development of interventions to target low health literacy populations could improve cervical cancer screening.

Assessment of Factors Associated With Parental Perceptions of Voluntary Decisions About Child Participation in Leukemia Clinical Trials

“…Finally, we used the NVS instrument 17 to assess HL because of our past experience with this HL assessment. 62 , 63 The strengths of the NVS include that it may be administered in 3 minutes, has been validated in both English and Spanish, and is highly sensitive for detecting limited HL. 17 , 22 The NVS primarily tests listening, reading, and numeracy skills, which are key skills in cancer; however, it may not fully address verbal and reasoning skills, writing, and understanding of health terminology.…”

The level of knowledge and associated socio-demographic factors on cervical cancer among women: a cross-sectional study at Kenyase Bosore community, Ghana

“…History of high-grade squamous intraepithelial lesions, history of cancer of the cervix, vagina, or vulva, and history of not getting routine Pap tests [5]. A Papanicolaou smear is a screening procedure that provides secondary prevention in the development of cervical cancer by detecting dysplastic cellular changes that may lead to cervical abnormalities [6]. The Pap smear has been the preferred prevention strategy for cervical cancer by periodically screening women to identify abnormal cells, to determine the need for additional procedures that can destroy the abnormal cells before they progress into invasive cancer [7].…”

Health Literacy among Medically Underserved: The Role of Demographic Factors, Social Influence, and Religious Beliefs

“…Department of Health and Human Services, 2010). Health literacy has been found to impact health status (Hoover et al, 2015; Sentell, Baker, Onaka, & Braun, 2011), medical decision-making (Wang et al, 2014), access to care (Levy & Janke, 2016), completion of positive health behaviors such as cancer screening (Fernandez, Larson, & Zikmund-Fisher, 2016; Heberer et al, 2016), and health outcomes (Scarpato et al, 2016). For example, individuals with inadequate self-reported health literacy have been found less likely to be adherent to mammography guidelines and to report regular moderate physical activity than those with adequate self-reported health literacy (Fernandez, Larson, & Zikmund-Fisher, 2016).…”