Journal of Cancer Survivorship

, Volume 11, Issue 3, pp 410–419 | Cite as

Cervical cancer screening for survivors diagnosed with cancer before age 25

  • Olivia L. Tseng
  • John J. Spinelli
  • Martin Dawes
  • Mary L. McBride
Article

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.

Keywords

Childhood cancers Survivorship research Pap test Cervical cancer screening Cancer follow-up care 

Abbreviations

ALL

Acute lymphocytic leukemia

AYA

Adolescent and Young Adult

BC

British Columbia

BCCA

British Columbia Cancer Agency

BCCH

British Columbia Children’s Hospital

CAYACS

Childhood, adolescent and young adult cancer survivor

CCSP

Cervical Cancer Screening Program

CCSS

Childhood Cancer Survivor Study

CI

Confidence interval

CNS

Central nervous system

ICCC

International Classification of Childhood Cancer

MSP

Medical Service Plan

Pap

Papanicolaou

PHNs

Personal Health Numbers

PRs

Prevalence ratios

PORs

Prevalence odds ratios

SAS

Statistical analysis system

SES

Socio-economic status

STROBE

Strengthening the Reporting of Observational Studies in Epidemiology

UBC

University of British Columbia

Supplementary material

11764_2017_598_MOESM1_ESM.pdf (237 kb)
ESM 1(PDF 237 kb)

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Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  • Olivia L. Tseng
    • 1
    • 2
  • John J. Spinelli
    • 1
    • 3
    • 4
  • Martin Dawes
    • 2
  • Mary L. McBride
    • 1
    • 4
  1. 1.Cancer Control Research Program, British Columbia Cancer Agency (BCCA)VancouverCanada
  2. 2.Department of Family PracticeUniversity of British ColumbiaVancouverCanada
  3. 3.Department of Statistics, Simon Fraser UniversityBurnabyCanada
  4. 4.School of Population and Public HealthUniversity of British ColumbiaVancouverCanada

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