381 Association between maternal birthplace and non catching-up among pregnant women overdue for cervical cancer screening

Abstract

In France, the HAS recommends performing a pap test every 3 years for all sexually active women aged from 25 to 65 years old. Currently, screening access is inequitable, and pregnancy may be an ideal moment to catch-up with women who are overdue for cervical cancer screening. As in general population, several social factors associated with place of birth are also associated with less access to screening. Our objective was to study the association between maternal place of birth and non catching-up during pregnancy among the sample of women from the National Perinatal Survey (ENP 2016). The National Perinatal Survey 2016 has included 13,147 women who delivered after 22 weeks in mainland France. The factors associated with non-catching up (defined by the lack of pap test during pregnancy for overdue women) has been modelled by log-binomial regression. Multivariate analysis was adjusted on level of education, health insurance and the moment of initiation of prenatal care. Among all women included in the National Perinatal Survey and concerned by screening, 43% were overdue. Among them, 45% of women were not caught-up during pregnancy. After adjustment on covariates, women born in Northern Africa had higher risk of being not caught-up than women born in France (adjusted RR 1.14 95% CI [1.03,1.26]). A low level of education and the late initiation of prenatal care were also associated with non-catching up. 45% of overdue women are not caught-up during pregnancy. Being born in Northern Africa increases the risk of being not caught-up.