Racial/Ethnic Disparities in Cervical Cancer Screening Services Among Contractors of the Connecticut Breast and Cervical Cancer Early Detection Program

Abstract

Purpose: Racial/ethnic minority women are at increased risk for cervical cancer. The objective of this study is to use performance management data from the Connecticut Breast and Cervical Cancer Early Detection Program (CBCCEDP) to determine whether race/ethnicity disparities exist in human papillomavirus (HPV) co-testing uptake across CBCCEDP contractors.Methods: Secondary analysis of Connecticut's Minimum Data Elements data for 2013–2015 among 10 contractors participating in the CBCCEDP. Participants included women aged 30–64 years and eligible to receive routine cervical cancer screening services through the CBCCEDP (n=5,262). HPV co-testing uptake was compared across contractors and race/ethnicity groups within each contractor using chi-square and Fisher's exact tests as appropriate.Results: Overall, 62.9% of women received HPV co-testing services. Significant differences in co-testing rates were detected between racial/ethnic groups when data were examined across all contractors (p<0.001). Black women were least likely to receive co-testing (49.1%), while Hispanic women were most likely to receive co-testing (68.2%). When data were examined at the individual contractor level, significant differences between racial/ethnic groups were observed in 50% of the contractors.Conclusions: This study identified racial/ethnic disparities in uptake of HPV co-testing both overall and within individual contractors involved in the CBCCEDP. These findings will be used to guide program improvement with the goal of increasing quality and consistency of care for all women seeking screening services.

Cervical cancer screening for individuals at average risk: 2020 guideline update from the American Cancer Society

“…There is some indication that women's acceptance of longer cervical cancer screening intervals has increased 54 . Concerns have been raised, however, that longer intervals may result in delays beyond the recommended time frames, potentially leading to lower overall adherence to cervical cancer screening recommendations 55 . Nonadherence to regular screening as individuals approach the age for cessation of screening 56 is of particular importance and may reduce the benefits.…”

Cervical Cancer Prevention in Racially Disparate Rural Populations

“…Cervical cancer (CC) is one of the leading causes of death among women [1,2,3,4,5,6,7]. In the United States, 13,170 new cases of CC are expected to be diagnosed with an estimated death of 4250 women in 2019 [3,4].…”

“…In the State of Texas, an estimated 1363 women are expected to be diagnosed and 431 are expected to die from the disease [3,4]. The frequency of CC incidence is higher in African-American and Hispanic women compared to Caucasian American women [5]. The major risk factors associated with CC development include high-risk human papilloma virus (hrHPV) infection, use of oral contraception, sexual promiscuity, cigarette smoking, childbirth, marital status and age [3,4,5,6].…”

“…The frequency of CC incidence is higher in African-American and Hispanic women compared to Caucasian American women [5]. The major risk factors associated with CC development include high-risk human papilloma virus (hrHPV) infection, use of oral contraception, sexual promiscuity, cigarette smoking, childbirth, marital status and age [3,4,5,6]. Among these various risk factors, persistent infection with hrHPV appears to be the major driver of CC development [1,2,3,4,5,6].…”

“…Thus, these medically underserved populations remain at greater risk of developing CC in their lifetime [3,9,10]. Preventative and strategic screening of these women is thus of paramount importance to reduce CC incidence and associated mortality [5,9,10,11,12].…”