Open AccessPredictors of Cervical Cancer Screening Among Infrequently Screened Women Completing Human Papillomavirus Self-Collection: My Body My Test-1
Author(s) -
C. Suzanne Lea,
Carolina Perez-Heydrich,
Andrea C. Des Marais,
Alice R. Richman,
Lynn Barclay,
Noel T. Brewer,
Jennifer S. Smith
Publication year - 2019
Publication title -
journal of women's health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.195
H-Index - 98
eISSN - 1931-843X
pISSN - 1540-9996
DOI - 10.1089/jwh.2018.7141
Subject(s) - medicine , pap test , papanicolaou stain , cervical cancer , logistic regression , family medicine , confidence interval , odds ratio , test (biology) , cervical cancer screening , cancer screening , gynecology , human papillomavirus , cancer , obstetrics , paleontology , biology
Background: Approximately one-half of cervical cancer cases in the United States occur in underscreened or never-screened women. We examined predictors to completing Papanicolaou (Pap) testing and whether a positive human papillomavirus (HPV) self-collection result affects Pap testing adherence among underscreened women. Materials and Methods: Low-income women aged 30-65 years who reported no Pap testing in ≥4 years were recruited in North Carolina. Knowledge, attitudes, and barriers regarding cervical cancer and Pap testing were assessed by telephone questionnaires. We mailed self-collection kits for HPV testing and provided information regarding where to obtain affordable Pap testing. Participants received $45 for completing all activities. We used multivariable logistic regression to assess the predictors of longer reported time since last Pap (≥10 vs. 4-9 years) and of completion of Pap testing following study enrollment (follow-up Pap). Results: Participants ( n = 230) were primarily black (55%), uninsured (64%), and with ≤high school education (59%). Cost and finding an affordable clinic were the most commonly reported barriers to screening. White women and those with ≤high school education reported longer intervals since last Pap test. Half of the participants reported completing a follow-up Pap test (55%). Women with a positive HPV self-collection were five times more likely to report completing a follow-up Pap test than those with negative self-collection (odds ratio = 5.1, 95% confidence interval 1.4-25.7). Conclusions: Improving awareness of resources for affordable screening could increase cervical cancer screening in underserved women. Home-based HPV self-collection represents an opportunity to re-engage infrequently screened women into preventive screening services.