National Trends and Disparities in Cervical Cancer Screening among Commercially Insured Women, 2001–2010

Abstract

Background: Previous surveys reported declining cervical cancer screening rates from 2000 to 2010, but trends by key demographic and age groups are less clear.Methods: We examined 3-year Papanicolaou (Pap) test rates among 4.2 million women enrolled in a large national health plan during 2001 to 2010. We calculated and plotted adjusted 3-year rates stratified by age and key neighborhood-level socioeconomic characteristics including poverty level and race/ethnicity (white, black, Hispanic, and mixed ethnicity neighborhood). We fitted trends in 2001-2010 screening rates and socioeconomic disparities as annual percentage changes (APC) using joinpoint analysis.Results: Women ages 21 to 29 years had estimated 3-year Pap testing rates of 81.3% to 81.4% over the decade. Estimated disparities by low-high poverty level were 3.1% and 2.0% in 2001-2003 and 2008-2010, respectively, a nonsignificant decline. Initial white-black disparities were 4.0% and declined significantly from 2005-2007 to 2008-2010 to 2.8% at an APC of À0.65% (P ¼ 0.021). White-Hispanic disparities declined from 4.3% to 0.8% over the decade, a À0.50% APC (P ¼ 0.024). Among women ages 30 to 64 years, estimated 3-year Pap testing rates trended down from 76.1% to 71.8% over the decade [À0.94% APC (P < 0.001) until [2005][2006][2007]. This pattern was similar among women from most categories of poverty and race/ethnicity.Conclusions: Among commercially insured women ages 21 to 29 years, 3-year Pap testing rates remained stable at 81% over the decade; disparities were small and improved for Hispanic women to a greater degree than for black women. Among women ages 30 to 64 years, 3-year Pap testing rates declined from 2001 to 2010.Impact: Cervical cancer screening should be promoted to achieve Healthy People 2020 goals. Cancer Epidemiol Biomarkers Prev; 23(11); 2366-73. Ó2014 AACR.

Examining the Cervical Screening Behaviour of Women Aged 50 or above and Its Predicting Factors: A Population-Based Survey

“…In the present study, fewer than half of Chinese older women had ever had a test, a lower rate than those reported by the comparable age group in other populations [16,17,19,20,21]. The majority of these women (65%) perceived their own low susceptibility to cancer, and 30% were unsure about their risk.…”

“…A structured questionnaire developed from the 2005 National Health Interview Survey cancer module [17] was used for the survey. It consisted of five parts: socio-demographic characteristics, health status and family history of cancer, perceived susceptibility to cancer and other health-related perceptions, utilisation of complementary medicine, and utilisation of cervical cancer screening.…”

Racial and Ethnic Disparities in the Quality of Health Care

“…State-level differences likely reflect differences in Medicaid eligibility, access to primary care, and probably regional attitudes. Differences in cancer screening by race or ethnicity among persons with similar types of insurance are relatively small (10,148,149). Compared with reports from non-Latino white patients, minority patients report less often that their providers recommend a colonoscopy, but these disparities disappear in some studies after accounting for patient-level factors (1).…”

Cancer statistics for Hispanics/Latinos, 2015

“…Although Hispanic women have historically been less likely to participate in cervical cancer screening compared with NHW women, the gap has narrowed in recent decades. [150][151][152] In 2013, 77% of Hispanic women were up-to-date with cervical cancer screening compared with 83% of NHW women; however, rates in Hispanics ranged from 73% in Cuban women to 83% in Puerto Rican women ( Table 7). The prevalence of Pap testing among uninsured Hispanic women (64%) is higher than among uninsured NHW women (57%), perhaps because low-income minorities are more adept at accessing safety net and subsidized programs.…”