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Differences in Cervical Cancer Screening Between African-American Versus African-Born Black Women in the United States

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Abstract

Although the incidence of cervical cancer has been declining steadily since the Pap smear became standard of care in the U.S., many African immigrants are unfamiliar with this screening test and its potential benefits. Using data from the CDC’s National Health Interview Surveys, we identified respondents who were black women living in the United States, distinguishing U.S.-born (n = 620) and African-born (n = 36). We constructed a measure of current Pap status and used multivariate logistic regression models to compare Pap status between the two groups. Controlling for income, age, education, health insurance, and marital status, African American women were over 3 times more likely to have reported a current Pap smear than African-born women [Adjusted OR = 3.37, 95 % CI = (1.89, 5.96)]. Being an African-born woman was the strongest predictor of current Pap status. Distinguishing immigrant status in an analysis of cervical cancer screening rates for black women indicated much lower Pap smear rates for African-born women, compared with African-American women. More research on the impact of education and culturally specific care is needed to address the disparity in Pap smear rates for African-born black women.

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Acknowledgments

A. Forney-Gorman would like to thank Ann D. Smith, M.D. for the helpful edits and comments on the article. The interviews performed for this project with Obsa Hassan, M.D., Fartun Weli, MPH and Rahel Ghebre, M.D. provided important insight for this research.

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Authors and Affiliations

  1. People’s Clinic in Minneapolis, Minnesota, 3441 St. Paul Ave., Minneapolis, MN, 55416, USA

    Alison Forney-Gorman

  2. Division of Biostatistics, Harvard School of Public Health, Boston, MA, USA

    Alison Forney-Gorman

  3. Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, MN, USA

    Katy B. Kozhimannil

Authors
  1. Alison Forney-Gorman
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  2. Katy B. Kozhimannil
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Corresponding author

Correspondence to Alison Forney-Gorman.

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Human Participant Protection

Data for this study included public use files from the Integrated Health Interview Series (IHIS). Research using IHIS files is exempt from IRB review as these are existing records that are de-identified and publicly available.

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Forney-Gorman, A., Kozhimannil, K.B. Differences in Cervical Cancer Screening Between African-American Versus African-Born Black Women in the United States. J Immigrant Minority Health 18, 1371–1377 (2016). https://doi.org/10.1007/s10903-015-0267-0

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  • DOI: https://doi.org/10.1007/s10903-015-0267-0

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