Abstract A121: Cervical cancer screening among Hispanic women in Lake County, Indiana: Knowledge, practices and willingness to adopt new testing methods
Authors: Claure Layla A. , Balian Lara , Rodriguez Natalia 
Published: September 2024

Abstract
Cervical cancer screening has significantly reduced incidence and mortality rates in the U.S., yet disparities in screening rates persist. Hispanic women are 40% more likely to be diagnosed and 30% more likely to die from cervical cancer compared to non-Hispanic whites. Indiana ranks among the top ten states with highest rates of cervical cancer mortality, with Lake County having the highest mortality rates and largest Hispanic population in the state. Clinical screening guidelines now include primary HPV testing without cytology allowing for innovations like HPV self-sampling and rapid testing, which can increase screening coverage among medically underserved populations. This study aimed to examine knowledge, practices, attitudes towards cervical cancer screening, and willingness to adopt screening innovations among Hispanic women in Lake County, Indiana. A mixed-methods study with an online cross-sectional survey of white, non-Hispanic and Hispanic individuals with a cervix aged 21-65 residing in Lake County (n=231), followed by in-depth interviews with a subset of Hispanic respondents (n=9). Outcome variables included cervical cancer knowledge, willingness to adopt HPV self-sampling at home/ in clinic, and willingness to adopt an HPV rapid test. A knowledge score was created using a scale based on 7 questions. Using SPSS, a t-test to compare knowledge score means and associations between demographic and outcome variables were analyzed. Interviews were thematically analyzed using NVIVO software. Most participants identified as Hispanic (58%) and were 31 or older (58%). 71.9% had been screened for cervical cancer, however, 24.7% reported never or being overdue for screening. There was a significant difference in means of knowledge scores between white, non-Hispanic (M=4.17, SD=2.25) and Hispanics (M=3.23, SD=2.15) (p-value &lt;.005). Among those willing to self-sample at home (51.9%), Hispanics were less willing (37.3%) compared to white, non-Hispanic (72.2%). Factors negatively associated with willingness to self-sample include being Hispanic (OR: 0.28, 95% CI: 0.13-0.62), having Medicaid (OR: 0.36, 95% CI: 0.14-0.94), and being uninsured (OR: 0.16, 95% CI: 0.05-0.60). Factors positively associated with willingness include never been married (OR: 2.75, 95% CI: 1.16-6.50), unemployed (OR: 2.75, 95% CI: 1.16-6.50), high-risk perception (OR: 2.79, 95% CI: 1.13-6.88), and having used rapid tests before (OR: 2.83, 95% CI: 1.13-7.31). Qualitative analysis identified concerns among participants about performing the test incorrectly (lack of self-efficacy) and remembering to perform the test. Benefits included increased comfort and less fear. While some testing methods are often considered more beneficial for cervical cancer screening among vulnerable populations, our study revealed that these populations may not readily accept or adopt them for various reasons. Understanding and addressing these is critical to increasing willingness to adopt new testing methods. Future efforts involve focus groups with Hispanic women to expand on these findings.
Citation Format: Layla A. Claure, Lara Balian, Natalia Rodriguez. Cervical cancer screening among Hispanic women in Lake County, Indiana: Knowledge, practices and willingness to adopt new testing methods [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr A121.