Cervical Cancer Screening Outcomes Among a Sample of Low-Income Uninsured Women: A Program-Based Study

Area of Science:

• Gynecology
• Public Health
• Epidemiology

Background:

• Cervical cancer screening research often focuses on insured populations, leaving outcomes for low-income, uninsured women understudied.
• Sociodemographic factors' impact on cervical cancer screening results is not well understood in vulnerable populations.
• Understanding screening outcomes in underserved groups is crucial for equitable healthcare delivery.

Purpose of the Study:

• To examine cervical cancer screening outcomes (Pap tests, HPV tests, colposcopies) in a sample of low-income, uninsured women.
• To analyze the association between screening outcomes and sociodemographic characteristics, including age, marital status, race/ethnicity, rurality, and screening history.
• To inform screening guidelines for underserved populations.

Main Methods:

• A grant-funded program provided Papanicolaou (Pap) tests, human papillomavirus (HPV) tests, and colposcopies to 841 women between 2013 and 2019.
• Screening outcomes were cross-tabulated with sociodemographic characteristics.
• Chi-squared and Fisher's exact tests were used to assess the independence of outcomes and characteristics.

Main Results:

• Overall positivity rates were 7.2% for Pap tests, 3.6% for HPV tests, and 44.7% for colposcopies.
• Pap test outcomes were not independent of patient age (p=0.009), with positivity increasing with age.
• Most screening outcomes were independent of other sociodemographic characteristics, potentially due to sample size limitations.

Conclusions:

• Findings support discontinuing cervical cancer screening for women over 65 who are at low risk.
• The study highlights challenges in researching health outcomes in low-income, uninsured populations due to data limitations.
• Further research is needed to fully understand screening outcome variations in underserved groups.