Deanna Kepka1, Nancy Breen2, Jessica B King3, Helen I Meissner4, Katherine B Roland5, Vicki B Benard5, Mona Saraiya5. 1. Huntsman Cancer Institute, Cancer Control and Population Sciences, University of Utah, College of Nursing, Salt Lake City, Utah; NIH, National Cancer Institute, Health Services and Economics Branch, Rockville. Electronic address: deanna.kepka@hci.utah.edu. 2. NIH, National Cancer Institute, Health Services and Economics Branch, Rockville. 3. CDC, Cancer Surveillance Branch. 4. NIH, Tobacco Regulatory Science Program, Office of Disease Prevention, Bethesda, Maryland. 5. CDC, National Center for Chronic Disease Prevention and Health Promotion, Division of Cancer Prevention and Control, Epidemiology and Applied Research Branch, Atlanta, Georgia.
Abstract
BACKGROUND: Since 2003, U.S. Preventive Services Task Force guidelines recommend against Pap testing for women without a cervix following a hysterectomy and those aged >65 years. Few population-based studies have investigated factors associated with overuse of Pap testing in the U.S. PURPOSE: To evaluate patient characteristics associated with overuse of Pap testing. METHODS: A cross-sectional study was conducted using data from the 2010 National Health Interview Survey (NHIS) for women aged ≥30 years. NHIS is a nationally representative survey that employs a random, stratified, multi-stage cluster sampling design. In 2010, the NHIS administered a Cancer Control Supplement with questions on cervical cancer screening and hysterectomy status. Conducted in 2011-2013, all analyses account for the stratification and clustering of data within the complex NHIS survey design. Multivariate logistic regression models were used in all analyses. RESULTS: Among women who have undergone a hysterectomy, younger age, Hispanic and black race/ethnicity, exceeding 400% of poverty level, and private health insurance coverage were significantly associated with receipt of a recent Pap test since hysterectomy. Among women aged >65 years, non-Hispanic white ethnicity, higher education level, exceeding 400% of poverty level, and no hysterectomy were significantly associated with receipt of a recent Pap test. CONCLUSIONS: Targeted efforts to reduce unnecessary testing among older women and women with a hysterectomy in compliance with clinical recommendations for cervical cancer prevention are needed. Specific attention should be paid to privately insured women with incomes above 400% of the federal poverty level.
BACKGROUND: Since 2003, U.S. Preventive Services Task Force guidelines recommend against Pap testing for women without a cervix following a hysterectomy and those aged >65 years. Few population-based studies have investigated factors associated with overuse of Pap testing in the U.S. PURPOSE: To evaluate patient characteristics associated with overuse of Pap testing. METHODS: A cross-sectional study was conducted using data from the 2010 National Health Interview Survey (NHIS) for women aged ≥30 years. NHIS is a nationally representative survey that employs a random, stratified, multi-stage cluster sampling design. In 2010, the NHIS administered a Cancer Control Supplement with questions on cervical cancer screening and hysterectomy status. Conducted in 2011-2013, all analyses account for the stratification and clustering of data within the complex NHIS survey design. Multivariate logistic regression models were used in all analyses. RESULTS: Among women who have undergone a hysterectomy, younger age, Hispanic and black race/ethnicity, exceeding 400% of poverty level, and private health insurance coverage were significantly associated with receipt of a recent Pap test since hysterectomy. Among women aged >65 years, non-Hispanic white ethnicity, higher education level, exceeding 400% of poverty level, and no hysterectomy were significantly associated with receipt of a recent Pap test. CONCLUSIONS: Targeted efforts to reduce unnecessary testing among older women and women with a hysterectomy in compliance with clinical recommendations for cervical cancer prevention are needed. Specific attention should be paid to privately insured women with incomes above 400% of the federal poverty level.
Authors: Emily McGinnis; Beth E Meyerson; Elissa Meites; Mona Saraiya; Rebecca Griesse; Emily Snoek; Laura Haderxhanaj; Lauri E Markowitz; William Smith Journal: Sex Transm Dis Date: 2017-10 Impact factor: 2.830
Authors: Erin J Aiello Bowles; Hongyuan Gao; Susan Brandzel; Susan Carol Bradford; Diana S M Buist Journal: Prev Med Date: 2016-01-25 Impact factor: 4.018
Authors: Wonsuk Yoo; Sangmi Kim; Warner K Huh; Sarah Dilley; Steven S Coughlin; Edward E Partridge; Yunmi Chung; Vivian Dicks; Jae-Kwan Lee; Sejong Bae Journal: PLoS One Date: 2017-02-24 Impact factor: 3.240