Abstract C62: Receipt of cervical cancer screening among women with access to care and other chronic diseases
Authors: Crawford Anatasha C. , Benard Vicki , King Jessica , Thomas Cheryll 
Published: March 2017

Background and Objectives: Cervical cancer screening can save lives when abnormal cervical lesions and early cancers are detected and treated, but many women are not screened as recommended. Limited or no access to health care is a known barrier to screening; however, in 2012, among women with no cervical cancer screening in the previous 5 years, nearly 70% had health insurance and a regular doctor or health care provider. This study examined the factors related to why women aged 40-65 with access to health care are not being screened for cervical cancer as recommended.

Methods: The 2014 Behavioral Risk Factor Surveillance System (BRFSS) survey was used to examine non-financial barriers to cervical cancer screening among women who reported insurance and a personal doctor or health care provider. Female respondents were asked if they had ever had a Pap test and if so, when this test was last performed. This study selected women who were aged 40-65 years, reported having medical insurance, at least one personal doctor or health care provider, no hysterectomy, or were not pregnant at the time of the survey. BRFSS data were weighted using advanced raking techniques. Chi-square testing was done to compare the characteristics of the respondents across screening history as screened versus never or rarely screened (more than 5 years).

Results: Of the women analyzed for this study, 9.1% were never or rarely screened for cervical cancer and had access to health care with insurance and with a regular health care provider. When compared to women receiving timely screening, women who were never or rarely screened for cervical cancer had a higher prevalence of ever reporting a chronic disease, including chronic obstructive pulmonary disease (COPD) (6% vs 13.7%), arthritis (31.4% vs 38.1), depression (22% vs 31.4%), or diabetes (9.6% vs 15.4%) (all p &lt; 0.01). Also, a significantly higher proportion of women who were never or rarely screened had more than 1 or 2 chronic diseases when compared to women screened on time (3-4 chronic diseases: 7.9% vs 16.6%, p=0.001). Women screened on time were more likely to have had no chronic disease (47.9%, p=0.001).

Conclusion: When we examined factors related to cervical cancer screening among women who reported having health insurance and access to a regular doctor or healthcare provider, a larger proportion of women with multiple chronic diseases reported not receiving the recommended screening for cervical cancer. The results of this study underscore the importance of examining the relationship between having multiple chronic diseases and specific barriers to cervical cancer screening. Additional research is recommended to determine if physicians and other health care providers can effectively balance managing patients' chronic diseases and ensuring that patients receive recommended preventive services.

Citation Format: Anatasha C. Crawford, Vicki Benard, Jessica King, Cheryll Thomas. Receipt of cervical cancer screening among women with access to care and other chronic diseases. [abstract]. In: Proceedings of the Ninth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2016 Sep 25-28; Fort Lauderdale, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2017;26(2 Suppl):Abstract nr C62.