Predictors of timely diagnostic follow-up after an abnormal Pap test among Hispanic women seeking care in El Paso, Texas

Carrillo, Thelma; Montealegre, Jane R.; Bracamontes, Christina; Scheurer, Michael E.; Follen, Michele; Mulla, Zuber D.

doi:10.1186/s12905-020-01161-9

Cited by 10 publications

(6 citation statements)

References 31 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In addition, there were demographic and socioeconomic variations in the characteristics of hot spots census tracts compared with cold spots and the rest of Texas. Our findings are consistent with previous studies investigating geographic clusters of cervical cancer incidence, stage at diagnosis, and mortality in the US . For example, Roche and colleagues examined invasive cervical cancers diagnosed in New Jersey from 2005 to 2009 and found spatial disparities in the distribution of cases.…”

Section: Discussionsupporting

confidence: 92%

“…Our findings are consistent with previous studies investigating geographic clusters of cervical cancer incidence, stage at diagnosis, and mortality in the US. 24 , 25 , 31 , 32 For example, Roche and colleagues 24 examined invasive cervical cancers diagnosed in New Jersey from 2005 to 2009 and found spatial disparities in the distribution of cases. The authors also reported racial and ethnic and socioeconomic differences in the characteristics of identified clusters of cases.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Geographic Variation in Late-Stage Cervical Cancer Diagnosis

Sokale,

Thrift,

Montealegre

et al. 2023

JAMA Netw Open

View full text Add to dashboard Cite

ImportanceThere are stark disparities in cervical cancer burden in the United States, notably by race and ethnicity and geography. Late-stage diagnosis is an indicator of inadequate access to and utilization of screening.ObjectiveTo identify geospatial clusters of late-stage cervical cancer at time of diagnosis in Texas.Design, Setting, and ParticipantsThis population-based cross-sectional study used incident cervical cancer data from the Texas Cancer Registry from 2014 to 2018 of female patients aged 18 years or older. Late-stage cervical cancer cases were geocoded at the census tract level (n = 5265) using their residential coordinates (latitude and longitude) at the time of diagnosis. Statistical analysis was performed from April to September 2023.ExposuresCensus tract of residence at diagnosis.Main Outcome and MeasuresLate-stage cervical cancer diagnosis (ie, cases classified by the National Cancer Institute Surveillance, Epidemiology and End Results summary stages 2 to 4 [regional spread] or 7 [distant metastasis]). A Poisson probability-based model of the SaTScan purely spatial scan statistics was applied at the census tract–level to identify geographic clusters of higher (hot spots) or lower (cold spots) proportions than expected of late-stage cervical cancer diagnosis and adjusted for age.ResultsAmong a total of 6484 female patients with incident cervical cancer cases (mean [SD] age, 48.7 [14.7] years), 2300 (35.5%) were Hispanic, 798 (12.3%) were non-Hispanic Black, 3090 (47.6%) were non-Hispanic White, and 296 (4.6%) were other race or ethnicity. Of the 6484 patients, 2892 with late-stage diagnosis (mean [SD] age, 51.8 [14.4] years were analyzed. Among patients with late-stage diagnosis, 1069 (37.0%) were Hispanic, 417 (14.4%) were non-Hispanic Black, 1307 (45.2%) were non-Hispanic White, and 99 (3.4%) were other race or ethnicity. SaTScan spatial analysis identified 7 statistically significant clusters of late-stage cervical cancer diagnosis in Texas, of which 4 were hot spots and 3 were cold spots. Hot spots included 1128 census tracts, predominantly in the South Texas Plains, Gulf Coast, and Prairies and Lakes (North Texas) regions. Of the 2892 patients with late-stage cervical cancer, 880 (30.4%) were observed within hot spots. Census tract–level comparison of characteristics of clusters suggested that hot spots differed significantly from cold spots and the rest of Texas by proportions of racial and ethnic groups, non–US born persons, and socioeconomic status.Conclusions and RelevanceIn this cross-sectional study examining geospatial clusters of late-stage cervical cancer diagnosis, place-based disparities were found in late-stage cervical cancer diagnosis in Texas. These findings suggest that these communities may benefit from aggressive cervical cancer interventions.

show abstract

Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Geographic Variation in Late-Stage Cervical Cancer Diagnosis

Sokale,

Thrift,

Montealegre

et al. 2023

JAMA Netw Open

View full text Add to dashboard Cite

show abstract

“…A synthesis of reviews of studies published between 1980 and 2008 highlights non-patient-level factors associated with improved colposcopy adherence, such as an urban setting, greater social support, or favorable perceived social norms ( Zapka et al, 2010 ). Most studies conducted in the United States reported the effects of patient individual characteristics and structural factors on colposcopy follow-up ( Carrillo et al, 2021 Jan 6 , Hui et al, 2014 Oct , Brooks et al, 2002 Jan , Miller et al, 2017 Jul ). Data are scarce regarding colposcopy adherence in Latin American and other low- and middle-income countries (LMICs).…”

Section: Introductionmentioning

confidence: 99%

Factors associated with receiving results and attending colposcopy in patients with positive HPV screens in Mexico City

León-Maldonado,

Hernández-Ramírez,

Torres-Ibarra

et al. 2023

Preventive Medicine Reports

View full text Add to dashboard Cite

“…Several studies have examined potential factors associated with colposcopy non-attendance [ 3 , 10 , 13 – 23 ]. However, most lack individual socio-demographic information [ 10 , 13 , 16 , 17 , 20 ], or are based on underserved populations such as migrants [ 13 , 14 ]. The role of HPV status on follow-up attendance was explored only recently in a small pilot study [ 24 ].…”

Section: Introductionmentioning

confidence: 99%

Colposcopy non-attendance following an abnormal cervical cancer screening result: a prospective population-based cohort study

et al. 2022

View full text Add to dashboard Cite

Background A considerable proportion of cervical cancer diagnoses in high-income countries are due to lack of timely follow-up of an abnormal screening result. We estimated colposcopy non-attendance, examined the potential factors associated and described non-attendance reasons in a population-based screening study. Methods Data from the MARZY prospective cohort study were analysed. Co-test screen-positive women (atypical squamous cells of undetermined significance or worse [ASC-US+] or high-risk human papillomavirus [hrHPV] positive) aged 30 to 65 years were referred to colposcopy within two screening rounds (3-year interval). Women were surveyed for sociodemographic, HPV-related and other data, and interviewed for non-attendance reasons. Logistic regression was used to examine potential associations with colposcopy attendance. Results At baseline, 2,627 women were screened (screen-positive = 8.7%), and 2,093 again at follow-up (screen-positive = 5.1%; median 2.7 years later). All screen-positives were referred to colposcopy, however 28.9% did not attend despite active recall. Among co-test positives (ASC-US+ and hrHPV) and only hrHPV positives, 19.6% were non-attendees. Half of only ASC-US+ screenees attended colposcopy. Middle age (adjusted odds ratio [aOR] = 1.55, 95% CI 1.02, 4.96) and hrHPV positive result (aOR = 3.04, 95% CI 1.49, 7.22) were associated with attendance. Non-attendance was associated with having ≥ 3 children (aOR = 0.32, 95% CI 0.10, 0.86). Major reasons for non-attendance were lack of time, barriers such as travel time, need for childcare arrangements and the advice against colposcopy given by the gynaecologist who conducted screening. Conclusions Follow-up rates of abnormal screening results needs improvement. A systematic recall system integrating enhanced communication and addressing follow-up barriers may improve screening effectiveness.

show abstract

Predictors of timely diagnostic follow-up after an abnormal Pap test among Hispanic women seeking care in El Paso, Texas

Cited by 10 publications

References 31 publications

Geographic Variation in Late-Stage Cervical Cancer Diagnosis

Geographic Variation in Late-Stage Cervical Cancer Diagnosis

Factors associated with receiving results and attending colposcopy in patients with positive HPV screens in Mexico City

Colposcopy non-attendance following an abnormal cervical cancer screening result: a prospective population-based cohort study

Contact Info

Product

Resources

About