Patterns and Correlates of Cervical Cancer Screening Initiation in a Large Integrated Healthcare System
ACOG ePoster. Lonky N. Apr 27, 2018; 211745
Neal Lonky
Neal Lonky
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Abstract
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Introduction: The cervical cancer incidence rate has not declined among 24-25 year-olds between 2000 (2.79 per 100,000) and 2013 (2.93 per 100,000). We studied cervical cancer screening initiation in young women and how woman and provider factors affect the timing of screening initiation to effect prevention. We examined patterns and correlates of cervical cancer screening initiation among women turning age 21 in a large community-based practice.

Methods: Female members who turned age 21 (baseline) during 2013-2015 and had not previously received Papanicolaou (Pap) test were evaluated during 2016 using electronic health records. Incidence rate and cumulative incidence of screening initiation was calculated. Associations between patient and provider characteristics and screening initiation were evaluated using multivariable Cox models.


Results: Of 38,257 women studied, the Pap screening initiation rate was 44 per 100 person-year(s) . Approximately 40% initiated screening within 1 year after turning age 21. I Asian/Pacific Islanders, Medicaid enrollees, those whose primary language is not English, those with a recent inpatient visit, those with a primary care physician (PCP) in specialties other than family practice,, and those cared for by a male rather than female PCP less often initiated screening. History of Human Papilloma virus and flu vaccination, ahistory of pregnancy, contraception use, and sexually transmitted infections had more timely screening initiation.

Conclusion/Implications: Less than half of the women insured for preventative services initiated screening at age 21. Strategies to improve adherence to screening initiation guidelines should consider a tailored approach for at risk subgroups and addressing initiation challenges associated with male physicians.
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