Olivia L Tseng1,2, John J Spinelli3,4,5, Martin Dawes6, Mary L McBride3,5. 1. Cancer Control Research Program, British Columbia Cancer Agency (BCCA), Vancouver, British Columbia, Canada. otseng@bccrc.ca. 2. Department of Family Practice, University of British Columbia, Vancouver, British Columbia, Canada. otseng@bccrc.ca. 3. Cancer Control Research Program, British Columbia Cancer Agency (BCCA), Vancouver, British Columbia, Canada. 4. Department of Statistics, Simon Fraser University, Burnaby, British Columbia, Canada. 5. School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada. 6. Department of Family Practice, University of British Columbia, Vancouver, British Columbia, Canada.
Abstract
PURPOSE: The study aims to better understand Pap test utilization for cancer survivors diagnosed before age 25 in British Columbia (BC), Canada. METHODS: A population-based cross-sectional data linkage study that included 1285 5-year female cancer survivors diagnosed with cancer before age 25 and 12,185 randomly selected and birth-year-matched BC female residents. Pap participation rates in 2008-2010, both uncorrected and corrected for hysterectomy status, were compared between two groups. Adjusted prevalence ratios (PRadj) were calculated to examine (1) associations between factors and Pap rates in each group and (2) interactions between factors and groups, using log-binomial regression models. RESULTS: Overall Pap rates, both uncorrected and corrected, were higher for survivors (71.8%; 72.9%) than population (69%; 69.7%). Pap rates were 4.8-5.1 and 17.8-22.4% higher for survivors aged 30-39 and 50-59 respectively. Significantly higher Pap test utilization was associated with previous Pap tests (PRadj = 1.83, 95%CI = 1.76-1.89) and previous cervical procedures (1.20, 95%CI = 1.15-1.25). Hysterectomy rates were doubled for survivors (7.4%) than population (3.7%). This did not affect Pap participation rate comparisons between two groups. In both groups, 51.6-70% of females with hysterectomies still received Pap tests. CONCLUSION: Survivors' Pap test utilization was significantly higher than population, but lower than the Canadian benchmark of 90%. Hysterectomy correction does not affect this observation. Cervical cancer screening is suboptimal for survivors. Females with prior hysterectomies might have received unnecessary Pap tests. IMPLICATIONS FOR CANCER SURVIVORS: Survivors without prior hysterectomies should continue to undergo Pap tests recommended by provincial guidelines, to optimize their health.
PURPOSE: The study aims to better understand Pap test utilization for cancer survivors diagnosed before age 25 in British Columbia (BC), Canada. METHODS: A population-based cross-sectional data linkage study that included 1285 5-year female cancer survivors diagnosed with cancer before age 25 and 12,185 randomly selected and birth-year-matched BC female residents. Pap participation rates in 2008-2010, both uncorrected and corrected for hysterectomy status, were compared between two groups. Adjusted prevalence ratios (PRadj) were calculated to examine (1) associations between factors and Pap rates in each group and (2) interactions between factors and groups, using log-binomial regression models. RESULTS: Overall Pap rates, both uncorrected and corrected, were higher for survivors (71.8%; 72.9%) than population (69%; 69.7%). Pap rates were 4.8-5.1 and 17.8-22.4% higher for survivors aged 30-39 and 50-59 respectively. Significantly higher Pap test utilization was associated with previous Pap tests (PRadj = 1.83, 95%CI = 1.76-1.89) and previous cervical procedures (1.20, 95%CI = 1.15-1.25). Hysterectomy rates were doubled for survivors (7.4%) than population (3.7%). This did not affect Pap participation rate comparisons between two groups. In both groups, 51.6-70% of females with hysterectomies still received Pap tests. CONCLUSION: Survivors' Pap test utilization was significantly higher than population, but lower than the Canadian benchmark of 90%. Hysterectomy correction does not affect this observation. Cervical cancer screening is suboptimal for survivors. Females with prior hysterectomies might have received unnecessary Pap tests. IMPLICATIONS FOR CANCER SURVIVORS: Survivors without prior hysterectomies should continue to undergo Pap tests recommended by provincial guidelines, to optimize their health.
Entities:
Keywords:
Cancer follow-up care; Cervical cancer screening; Childhood cancers; Pap test; Survivorship research
Authors: Lisa Diller; Eric J Chow; James G Gurney; Melissa M Hudson; Nina S Kadin-Lottick; Toana I Kawashima; Wendy M Leisenring; Lillian R Meacham; Ann C Mertens; Daniel A Mulrooney; Kevin C Oeffinger; Roger J Packer; Leslie L Robison; Charles A Sklar Journal: J Clin Oncol Date: 2009-04-13 Impact factor: 44.544
Authors: Eva Grunfeld; Rahim Moineddin; Nadia Gunraj; M Elisabeth Del Giudice; David C Hodgson; Janice S Kwon; Laurie Elit Journal: Can Fam Physician Date: 2012-09 Impact factor: 3.275
Authors: Mary L McBride; Paul C Rogers; Sam B Sheps; Victor Glickman; Anne-Marie Broemeling; Karen Goddard; Joan Hu; Maria Lorenzi; Stuart Peacock; Sheila Pritchard; Shahrad Rod Rassekh; Linda Siegel; John J Spinelli; Paulos Teckle; Lijing Xie Journal: Pediatr Blood Cancer Date: 2010-08 Impact factor: 3.167
Authors: J P Neglia; D L Friedman; Y Yasui; A C Mertens; S Hammond; M Stovall; S S Donaldson; A T Meadows; L L Robison Journal: J Natl Cancer Inst Date: 2001-04-18 Impact factor: 11.816
Authors: Hilary C Tanenbaum; Lanfang Xu; Erin E Hahn; Julie Wolfson; Smita Bhatia; Kim Cannavale; Robert Cooper; Chun Chao Journal: Prev Med Rep Date: 2020-12-01