Correlates of Cervical Cancer Screening Adherence Among Women in the U.S.: Findings from HINTS 2013–2014

Luque, John S.; Tarasenko, Yelena N.; Chen, Chen

doi:10.1007/s10935-018-0513-z

Original Paper
Published: 06 June 2018

Correlates of Cervical Cancer Screening Adherence Among Women in the U.S.: Findings from HINTS 2013–2014

John S. Luque¹,
Yelena N. Tarasenko^2,3 &
Chen Chen⁴

The Journal of Primary Prevention volume 39, pages 329–344 (2018)Cite this article

791 Accesses
7 Citations
8 Altmetric
Metrics details

Abstract

Following the latest update of cervical cancer screening guidelines in 2012, we estimate the prevalence of guideline adherent cervical cancer screening and examine its associated factors among a nationally representative sample of US women aged 21–65 years. Our study was based on cross-sectional data from Cycles 3 (2013) and 4 (2014) of the Health Information National Trends Survey. The final analytic sample consisted of 2822 women. Guideline adherent cervical cancer screening was defined as having a Pap test within the last 3 years. Correlates of guideline adherent cervical cancer screening included socio-demographic and health-related characteristics and HPV/cervical cancer-related beliefs and knowledge items. Multivariable logistic regression analyses were used to estimate prevalence of guideline adherent screening. An estimated 81.3% of women aged 21–65 years reported being screened for cervical cancer within the last 3 years. Controlling for sociodemographic and health-related characteristics and survey year, women aged 46–65 years were less likely to be guideline adherent than those aged 21–30 years (aPR = 0.89; 95% CI 0.82–0.97). The adjusted prevalence of adherence was significantly higher among married/partnered than among not married women (aPR = 1.13; 95% CI 1.05–1.22), and those with one to three medical visits (aPR = 1.30; 95% CI 1.14–1.48), and four or more visits in the past year (aPR = 1.26; 95% CI 1.09–1.45) compared to those with no medical visits. Differences in unadjusted prevalence of guideline adherent screening depending on women’s beliefs and knowledge about HPV and cervical cancer were not significant in adjusted analyses. Lack of interaction with a healthcare provider, being not married/partnered and increasing age continue to be risk factors of foregoing guideline adherent cervical cancer screening.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

USD 39.95

Price includes VAT (USA)
Tax calculation will be finalised during checkout.

References

ACOG. (2016). Practice Bulletin No. 157: Cervical cancer screening and prevention. Obstetrics and Gynecology, 127(1), e1–e20. https://doi.org/10.1097/AOG.0000000000001263.
Article Google Scholar
Akers, A. Y., Newmann, S. J., & Smith, J. S. (2007). Factors underlying disparities in cervical cancer incidence, screening, and treatment in the United States. Current Problems in Cancer, 31(3), 157–181. https://doi.org/10.1016/j.currproblcancer.2007.01.001.
Article PubMed Google Scholar
Ashok, M., Berkowitz, Z., Hawkins, N. A., Tangka, F., & Saraiya, M. (2012). Recency of Pap testing and future testing plans among women aged 18–64: Analysis of the 2007 Health Information National Trends Survey. Journal of Women’s Health (Larchment), 21(7), 705–712. https://doi.org/10.1089/jwh.2012.3562.
Article Google Scholar
Benard, V. B., Greek, A., Roland, K. B., Hawkins, N. A., Lin, L., & Saraiya, M. (2016). Change in provider beliefs regarding cervical cancer screening intervals after an educational intervention. Journal of Women’s Health (Larchment), 25(5), 422–427. https://doi.org/10.1089/jwh.2015.5706.
Article Google Scholar
Bieler, G. S., Brown, G. G., Williams, R. L., & Brogan, D. J. (2010). Estimating model-adjusted risks, risk differences, and risk ratios from complex survey data. American Journal of Epidemiology, 171(5), 618–623. https://doi.org/10.1093/aje/kwp440.
Article PubMed Google Scholar
Castanon, A., Landy, R., Cuzick, J., & Sasieni, P. (2014). Cervical screening at age 50–64 years and the risk of cervical cancer at age 65 years and older: Population-based case control study. PLoS Medicine, 11(1), e1001585. https://doi.org/10.1371/journal.pmed.1001585.
Article PubMed PubMed Central Google Scholar
Centers for Disease Control and Prevention. (2015). BRFSS prevalence and trends data. Retrieved September 17, 2017 from https://www.cdc.gov/brfss/brfssprevalence/.
Centers for Disease Control and Prevention. (2017). Cervical cancer statistics. Retrieved September 17, 2017 from https://www.cdc.gov/cancer/cervical/statistics/index.htm.
Cooper, C. P., Saraiya, M., & Sawaya, G. F. (2015). Acceptable and preferred cervical cancer screening intervals among U.S. women. American Journal of Preventive Medicine, 49(6), e99–107. https://doi.org/10.1016/j.amepre.2015.04.025.
Article PubMed PubMed Central Google Scholar
Coronado, G. D., Petrik, A., Spofford, M., Talbot, J., Do, H. H., Sanchez, J., et al. (2013). Perceptions of under and overutilization of cervical cancer screening services at Latino-serving community health centers. Journal of Community Health, 38(5), 915–918. https://doi.org/10.1007/s10900-10013-19701-10901.
Article PubMed Google Scholar
Cowburn, S., Carlson, M. J., Lapidus, J. A., & DeVoe, J. E. (2013). The association between insurance status and cervical cancer screening in community health centers: Exploring the potential of electronic health records for population-level surveillance, 2008–2010. Preventing Chronic Disease, 10, E173. https://doi.org/10.5888/pcd5810.130034.
Article PubMed PubMed Central Google Scholar
Eggleston, K. S., Coker, A. L., Das, I. P., Cordray, S. T., & Luchok, K. J. (2007). Understanding barriers for adherence to follow-up care for abnormal pap tests. Journal of Women’s Health (Larchment), 16(3), 311–330. https://doi.org/10.1089/jwh.2006.0161.
Article Google Scholar
El-Haddad, B., Dong, F., Kallail, K. J., Hines, R. B., & Ablah, E. (2015). Association of marital status and colorectal cancer screening participation in the USA. Colorectal Disease, 17(5), 108–114. https://doi.org/10.1111/codi.12926.
Article Google Scholar
Hanske, J., Meyer, C. P., Sammon, J. D., Choueiri, T. K., Menon, M., Lipsitz, S. R., et al. (2016). The influence of marital status on the use of breast, cervical, and colorectal cancer screening. Preventive Medicine, 89, 140–145. https://doi.org/10.1016/j.ypmed.2016.05.017.
Article PubMed Google Scholar
Hirth, J. M., Laz, T. H., Rahman, M., & Berenson, A. B. (2016). Racial/Ethnic differences affecting adherence to cancer screening guidelines among women. Journal of Women’s Health (Larchment), 25(4), 371–380. https://doi.org/10.1089/jwh.2015.5270.
Article Google Scholar
Katz, M. L., Reiter, P. L., Young, G. S., Pennell, M. L., Tatum, C. M., & Paskett, E. D. (2015). Adherence to multiple cancer screening tests among women living in Appalachia Ohio. Cancer Epidemiology, Biomarkers and Prevention, 24(10), 1489–1494. https://doi.org/10.1158/1055-9965.EPI-15-0369.
Article PubMed Google Scholar
Kauffman, R. P., Griffin, S. J., Lund, J. D., & Tullar, P. E. (2013). Current recommendations for cervical cancer screening: Do they render the annual pelvic examination obsolete? Medical Principals and Practice, 22(4), 313–322. https://doi.org/10.1159/000346137.
Article Google Scholar
Luque, J. S., Tyson, D. M., Markossian, T., Lee, J. H., Turner, R., Proctor, S., et al. (2011). Increasing cervical cancer screening in a Hispanic migrant farmworker community through faith-based clinical outreach. Journal of Lower Genital Tract Disease, 15(3), 200–204. https://doi.org/10.1097/LGT.1090b1013e318206004a.
Article PubMed PubMed Central Google Scholar
Moyer, V. A., & U.S. Preventive Services Task Force. (2012). Screening for cervical cancer: U.S. Preventive Services Task Force recommendation statement. Annals of Internal Medicine, 156(12), 880–891. https://doi.org/10.7326/0003-4819-156-12-201206190-00424.
Article PubMed Google Scholar
Nagler, R. H., Lueck, J. A., & Gray, L. S. (2017). Awareness of and reactions to mammography controversy among immigrant women. Health Expectations, 20(4), 638–647. https://doi.org/10.1111/hex.12494.
Article PubMed Google Scholar
National Cancer Institute. (2016). Health information national trends survey (HINTS). Retrieved April 7, 2016 from http://hints.cancer.gov.
Nelson, W., Moser, R. P., Gaffey, A., & Waldron, W. (2009). Adherence to cervical cancer screening guidelines for U.S. women aged 25–64: Data from the 2005 Health Information National Trends Survey (HINTS). Journal of Women’s Health (Larchment), 18(11), 1759–1768. https://doi.org/10.1089/jwh.2009.1430.
Article Google Scholar
Ojeaga, A., Alema-Mensah, E., Rivers, D., Azonobi, I., & Rivers, B. (2017). Racial disparities in HPV-related knowledge, attitudes, and beliefs among African American and White women in the USA. Journal of Cancer Education. https://doi.org/10.1007/s13187-017-1268-6.
PubMed Article Google Scholar
Rauscher, G. H., Johnson, T. P., Cho, Y. I., & Walk, J. A. (2008). Accuracy of self-reported cancer-screening histories: A meta-analysis. Cancer Epidemiology, Biomarkers and Prevention, 17(4), 748–757. https://doi.org/10.1158/1055-9965.EPI-07-2629.
Article PubMed Google Scholar
Roland, K. B., Benard, V. B., Greek, A., Hawkins, N. A., & Lin, L. (2016). Changes in knowledge and beliefs about human papillomavirus and cervical cancer screening intervals in low-income women after an educational intervention. Journal of Primary Care and Community Health, 7(2), 88–95. https://doi.org/10.1177/2150131915624869.
Article PubMed Google Scholar
Rositch, A. F., Nowak, R. G., & Gravitt, P. E. (2014). Increased age and race-specific incidence of cervical cancer after correction for hysterectomy prevalence in the United States from 2000 to 2009. Cancer, 120(13), 2032–2038. https://doi.org/10.1002/cncr.28548.
Article PubMed PubMed Central Google Scholar
Rosser, J. I., Zakaras, J. M., Hamisi, S., & Huchko, M. J. (2014). Men’s knowledge and attitudes about cervical cancer screening in Kenya. BMC Women’s Health, 14, 138. https://doi.org/10.1186/s12905-014-0138-1.
Article PubMed PubMed Central Google Scholar
Sabatino, S. A., White, M. C., Thompson, T. D., Klabunde, C. N., & Centers for Disease, C., & Prevention. (2015). Cancer screening test use—United States, 2013. Morbidity and Mortality Weekly Report, 64(17), 464–468.
PubMed PubMed Central Google Scholar
Saraiya, M., Berkowitz, Z., Yabroff, K. R., Wideroff, L., Kobrin, S., & Benard, V. (2010). Cervical cancer screening with both human papillomavirus and Papanicolaou testing vs Papanicolaou testing alone: What screening intervals are physicians recommending? Archives of Internal Medicine, 170(11), 977–985. https://doi.org/10.1001/archinternmed.2010.134.
Article PubMed Google Scholar
Saslow, D., Solomon, D., Lawson, H. W., Killackey, M., Kulasingam, S. L., Cain, J., et al. (2012). American cancer society, American society for colposcopy and cervical pathology, and American society for clinical pathology screening guidelines for the prevention and early detection of cervical cancer. CA: A Cancer Journal for Clinicians, 62(3), 147–172. https://doi.org/10.3322/caac.21139.
Article Google Scholar
Shoemaker, M. L., & White, M. C. (2016). Breast and cervical cancer screening among Hispanic subgroups in the USA: Estimates from the National Health Interview Survey 2008, 2010, and 2013. Cancer Causes and Control. https://doi.org/10.1007/s10552-016-0718-5.
Article PubMed Google Scholar
Smith, J. S., Brewer, N. T., Saslow, D., Alexander, K., Chernofsky, M. R., Crosby, R., et al. (2013). Recommendations for a national agenda to substantially reduce cervical cancer. Cancer Causes and Control, 24(8), 1583–1593. https://doi.org/10.1007/s10552-013-0235-8.
Article PubMed Google Scholar
Smith, R. A., Manassaram-Baptiste, D., Brooks, D., Doroshenk, M., Fedewa, S., Saslow, D., et al. (2015). Cancer screening in the United States, 2015: A review of current American Cancer Society guidelines and current issues in cancer screening. CA: A Cancer Journal for Clinicians, 65(1), 30–54. https://doi.org/10.3322/caac.21261.
Article Google Scholar
Spence, A. R., Goggin, P., & Franco, E. L. (2007). Process of care failures in invasive cervical cancer: Systematic review and meta-analysis. Preventive Medicine, 45(2–3), 93–106. https://doi.org/10.1016/j.ypmed.2007.06.007.
Article PubMed Google Scholar
Studts, C. R., Tarasenko, Y. N., Schoenberg, N. E., Shelton, B. J., Hatcher-Keller, J., & Dignan, M. B. (2012). A community-based randomized trial of a faith-placed intervention to reduce cervical cancer burden in Appalachia. Preventive Medicine, 54(6), 408–414. https://doi.org/10.1016/j.ypmed.2012.03.019.
Article PubMed PubMed Central Google Scholar
Sung, H. Y., Kearney, K. A., Miller, M., Kinney, W., Sawaya, G. F., & Hiatt, R. A. (2000). Papanicolaou smear history and diagnosis of invasive cervical carcinoma among members of a large prepaid health plan. Cancer, 88(10), 2283–2289.
Article PubMed CAS Google Scholar
U.S. Department of Health and Human Services (2016). Healthy People 2020. Retrieved January 22, 2016 from https://www.healthypeople.gov/2020/topics-objectives/topic/cancer/objectives.
U.S. Preventive Services Task Force. (2012). Cervical cancer: Screening. Retrieved March 8, 2016 from http://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/cervical-cancer-screening.
Walsh, B., & O’Neill, C. (2015). Socioeconomic disparities across ethnicities: An application to cervical cancer screening. American Journal of Managed Care, 21(9), e527–e536.
PubMed Google Scholar
Westat. (2014). Health information national trends survey 4 (HINTS 4) Cycle 3 methodology report. Retrieved April 7, 2016 from http://hints.cancer.gov.
Westat. (2015). Health information national trends survey 4 (HINTS 4) Cycle 4 methodology report. Retrieved April 7, 2016 from http://hints.cancer.gov.
White, M. C., Shoemaker, M. L., & Benard, V. B. (2017). Cervical cancer screening and incidence by age: Unmet needs near and after the stopping age for screening. American Journal of Preventive Medicine, 53(3), 392–395. https://doi.org/10.1016/j.amepre.2017.02.024.
Article PubMed PubMed Central Google Scholar

Download references

Acknowledgements

Research supported in part by institutional research funding, Hollings Cancer Centers’ Cancer Center Support Grant P30 CA138313 at the Medical University of South Carolina from the National Cancer Institute. The research presented in this paper is that of the authors and does not reflect the official policy of the National Institutes of Health.

Author information

Authors and Affiliations

Institute of Public Health, Florida A&M University, 1515 South MLK Blvd., Ste. 207B, Tallahassee, FL, 32307, USA
John S. Luque
Department of Health Policy and Management, Georgia Southern University, Statesboro, GA, USA
Yelena N. Tarasenko
Department of Epidemiology, Georgia Southern University, Statesboro, GA, USA
Yelena N. Tarasenko
College of Nursing and Health Professions, University of Southern Indiana, Evansville, IN, USA
Chen Chen

Authors

John S. Luque
View author publications
You can also search for this author in PubMed Google Scholar
Yelena N. Tarasenko
View author publications
You can also search for this author in PubMed Google Scholar
Chen Chen
View author publications
You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to John S. Luque.

Ethics declarations

Conflict of Interest

The authors declare they have no conflicts of interest.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Luque, J.S., Tarasenko, Y.N. & Chen, C. Correlates of Cervical Cancer Screening Adherence Among Women in the U.S.: Findings from HINTS 2013–2014. J Primary Prevent 39, 329–344 (2018). https://doi.org/10.1007/s10935-018-0513-z

Download citation

Published: 06 June 2018
Issue Date: August 2018
DOI: https://doi.org/10.1007/s10935-018-0513-z

Keywords

Cervical cancer
Pap test
Cancer screening