Cervical Cancer Screening and Prevention among Latinas in the United States among a Network of Community Health...

Timely cervical cancer screenings are critical for middle-aged to older Latinas. However, little is currently known about screening in this population. Latinas tend to receive disproportionate care in community health centers (CHC).

A retrospective analysis of electronic health record data from a national network of US CHCs included Latinas and non-Hispanic Whites (NHW) aged >45 with known birth country and at least one in-person primary care visit between 2014 and 2022, across 527 community-based clinics in 15 states. We used generalized estimating equations logistic regression to examine covariate-adjusted receipt of cytology, overall and by country of origin.

Among 34,135 patients, Mexican Latinas had the highest unadjusted prevalence of receiving cytology or cotesting at 56%, whereas NHWs had the lowest prevalence at 37%. We found that Latina groups, except for US-born Latinas, individually had higher odds of receiving cytology or cotesting compared with NHWs. Latina groups born in Mexico [OR (95% confidence interval, CI), 1.44 (1.09-1.90)], Honduras [OR (95% CI), 1.39 (1.06-1.82)], El Salvador [OR (95% CI), 1.38 (1.09-1.73)], and Nicaragua [OR (95% CI), 1.36 (1.01-1.83)] had higher odds than NHWs.

CHCs have important strengths in reaching diverse patient populations, with higher rates of cervical cancer screening in middle-aged to older Latinas than NHWs.

This study adds novel information about screening rates among a heterogeneous sample outside of their reproductive years and in a large, multistate sample of CHCs. We add to a growing body of literature about the distinctive environment of CHCs.