Individual and Geographical Factors Associated With Follow-Up Care After an Abnormal Cervical Cancer Screening Result

Area of Science:

• Public Health
• Epidemiology
• Gynecologic Oncology

Background:

• Cervical cancer prevention relies on guideline-concordant screening and prompt follow-up of abnormal results.
• Timely diagnosis and treatment are crucial for improving patient outcomes and reducing cancer mortality.

Purpose of the Study:

• To identify factors associated with follow-up care after abnormal cervical cancer screening.
• To examine individual and neighborhood-level predictors of colposcopy completion in Mississippi.

Main Methods:

• Retrospective analysis of electronic health records from the STRIDES cohort (2018-2021).
• Multilevel logistic regression models assessed associations between individual/neighborhood factors and follow-up colposcopy.
• Variables included age, race, cytology results, region, driving distance, rurality, and social vulnerability.

Main Results:

• Younger age (<30), Northern/Central region residence, non-Hispanic Asian race, and increased driving distance were associated with less documented follow-up.
• Abnormal cytology results increased likelihood of follow-up compared to normal cytology with high-risk HPV.
• Follow-up likelihood increased with the severity of cytological abnormality.

Conclusions:

• Individual and geographic factors (age, location, distance, cytology severity) significantly impact cervical cancer follow-up care.
• Findings will guide interventions to reduce barriers and improve access to cervical cancer care.
• Addressing identified disparities is essential for statewide cervical cancer prevention efforts.