Rural-urban differences in HPV testing for cervical cancer screening

Area of Science:

• Public Health
• Oncology
• Epidemiology

Background:

• Rural populations often face healthcare access challenges contributing to cancer disparities.
• Cervical cancer incidence and mortality are higher in rural areas.
• Existing research often focuses on Pap testing, not the more sensitive HPV testing for cervical cancer screening.

Purpose of the Study:

• To examine urban-rural differences in cervical cancer screening rates.
• To specifically investigate the uptake of HPV testing versus Pap testing in rural versus urban populations.
• To understand factors contributing to cervical cancer screening disparities in rural women.

Main Methods:

• Logistic regression analysis of data from the 2016 and 2018 Behavioral Risk Factor Surveillance System.
• Examination of cervical cancer screening rates based on national guidelines.
• Propensity score weighting used to control for sociodemographic differences in the 2016 landline sample.

Main Results:

• Rural women were less likely than urban women to have current cervical cancer screening in 2016 and 2018.
• Sociodemographic factors explained the screening disparity in 2016.
• Among women screened, rural women were significantly less likely to undergo HPV testing than urban women in both years.

Conclusions:

• Rural women with cervical cancer screening are less likely to receive HPV testing compared to urban women.
• Potential reasons include delayed guideline updates for rural providers, patient unawareness, or practice integration challenges.
• Reduced HPV testing may lead to delayed diagnosis and contribute to rural-urban cervical cancer disparities.