Abstract 3610: Cervical cancer screening and sexual risky behaviors among a population of Hispanic origin.
Authors: Gonzalez Daisy , Suarez Erick , Perez Cynthia M. , Soto-Salgado Marievelisse , Marrero Edmir , Ortiz Ana P. 
Published: August 2014

Background: Cervical cancer is the fifth most commonly diagnosed cancer in women living in Puerto Rico (PR). The leading cause of cervical cancer is infection with high-risk types of human papilloma virus (HPV). Thus, women with risky sexual behaviors may be at high risk of HPV infection, which in turn, increase the risk of cervical cancer. Pap-test screening has demonstrated to be effective in reducing the burden of cervical cancer, although its use has been observed to vary among certain population subgroups, including Hispanics.

Objective: This study assessed the prevalence of cervical cancer screening utilization and its association with sexual behaviors among a population-based sample of Hispanic women in PR.

Methods: This study was a secondary data analysis of the database of an ongoing cross-sectional study of HPV infection in PR (2010-2012). The study group was identified through a complex sampling design of households in the San Juan Metropolitan Area, and included non-institutionalized women aged 16-64 years old residing in this area. The data were collected by means of personalized and computer assisted interviews. Sexual risky behavior was defined as an index that considered the following sexual behaviors: early age of sexual debut (≤15 years), ≥11 lifetime sexual partners and ≥2 sexual partners in the last year. Multivariable logistic regression was used to estimate the odds ratio (OR) to determine the strength of the association between sexual risk behavior and Pap test utilization, after adjusting for socioeconomic characteristics.

Results: Mean age of participants was 43.1±13.1 years, 70.5% had achieved less than bachelor's degree education and 9.43% had no health care coverage. Overall, 78.9% of respondents reported to have had a Pap test within the last 3 years. Multivariate logistic regression showed that women with two or three risky sexual behaviors were less likely to have had a Pap test within the past 3 years (OR: 0.45, 95% CI: 0.23, 0.88) when compared to those with none or one risky sexual behavior, after adjusting for age, educational attainment, smoking status and STI history.

Conclusions: The prevalence of cervical cancer screening in this population is still below Healthy People 2020 recommendations (93%). Our study results also suggest that women with risky sexual behavior at high risk for HPV infection and cervical cancer development) are less likely to use cervical cancer screening. Efforts to promote cervical screening programs should focus on these high risk women, as a method for cervical cancer prevention and control.

Citation Format: Daisy Gonzalez, Erick Suarez, Cynthia M. Perez, Marievelisse Soto-Salgado, Edmir Marrero, Ana P. Ortiz. Cervical cancer screening and sexual risky behaviors among a population of Hispanic origin. [abstract]. In: Proceedings of the 104th Annual Meeting of the American Association for Cancer Research; 2013 Apr 6-10; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2013;73(8 Suppl):Abstract nr 3610. doi:10.1158/1538-7445.AM2013-3610