Abstract B10: Predictors of timely attendance for colposcopy following an abnormal Pap test among Hispanic women on the Texas-Mexico border
Authors: Carrillo Thelma , Montealegre Jane , Perkins Tara G. , Gutierrez Christina M. , Fradkin Leonid , Palomino Javier , Castro Felipe , Follen Michele , Mulla Zuber D. 
Published: October 2015

Introduction: Organized Pap test screening programs have led to a dramatic decrease in cervical cancer incidence in the U.S. and other developed countries. However, the success of screening relies on subsequent attendance for colposcopy and other follow-up procedures among women with an abnormal Pap test. Timely follow-up to colposcopy is a common problem in many populations, especially ethnic minorities and the medically underserved. The purpose of this study was to identify characteristics associated with timely follow-up to colposcopy among Hispanic women living on the Texas-Mexico border.

Methods: We analyzed data on 244 Hispanic patients attending a colposcopy clinic at an academic medical center in El Paso, Texas. The dichotomous outcome variable was timely follow-up to colposcopy following an abnormal Pap. Specifically, participants were considered to have timely follow-up if the interval between the date of their last abnormal Pap test and the date of their colposcopy was 90 days or less. A generalized linear model was fit using a binomial distribution and log link. Risk ratios (RR), 95% confidence intervals (CI), and P values for an optimal interval were calculated from this log-binomial model.

Results: Overall, 115 (47.1%) of women were born in Mexico. The median age was 30.9 years (52.9% of the sample was 30 years or older), 15.6% had completed 4 or more years of college 50.4 % were participants in the Breast and Cervical Cancer Services (BCCS) program, 47.1% were more acculturated versus less acculturated according to the Marín Short Acculturation Scale for Hispanics, 13.5% had an immediate family member who had developed cervical cancer, 23.4% had smoked at least 100 cigarettes in her life, approximately 16% had a Pap smear with one of the following results: atypical squamous cells where a high-grade squamous intraepithelial lesion (SIL) can't be excluded, high-grade SIL, cervical cancer. Overall, 160 of the 244 women (65.6%) had timely follow-up to colposcopy. No associations were detected between timely follow-up and acculturation, education, smoking history, family history of cervical cancer, Pap smear grade, and BCCS participant status. Women who were 30 years of age or older were 33% more likely to have an optimal interval than younger women after adjusting for the remaining variables (RR=1.33, 95% CI: 1.09-1.63, P=0.01).

Conclusions: Over one-third of Hispanic women in our sample did not obtain timely follow-up to colposcopy following an abnormal Pap. Consistent with other studies, older women (age ≥30 years in our study) were more likely than younger women to have timely follow-up. Further research is needed to better understand barriers to timely follow-up to colposcopy among Hispanic women seeking care on the Texas-Mexico border.

Citation Format: Thelma Carrillo, Jane Montealegre, Tara G. Perkins, Christina M. Gutierrez, Leonid Fradkin, Javier Palomino, Felipe Castro, Michele Follen, Zuber D. Mulla. Predictors of timely attendance for colposcopy following an abnormal Pap test among Hispanic women on the Texas-Mexico border. [abstract]. In: Proceedings of the Seventh AACR Conference on The Science of Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; Nov 9-12, 2014; San Antonio, TX. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2015;24(10 Suppl):Abstract nr B10.