Cervical Cancer Screening Barriers and Risk Factor Knowledge Among Uninsured Women

Marvellous Akinlotan,David Mcclellan,Chinedum Ojinnaka,Jane N Bolin,Anna Lichorad,Janet Helduser

doi:10.1007/s10900-017-0316-9

Abstract

A steady decline in cervical cancer incidence and mortality in the United States has been attributed to increased uptake of cervical cancer screening tests such as Papanicolau (Pap) tests. However, disparities in Pap test compliance exist, and may be due in part to perceived barriers or lack of knowledge about risk factors for cervical cancer. This study aimed to assess correlates of cervical cancer risk factor knowledge and examine socio-demographic predictors of self-reported barriers to screening among a group of low-income uninsured women. Survey and procedure data from 433 women, who received grant-funded cervical cancer screenings over a span of 33 months, were examined for this project. Data included demographics, knowledge of risk factors, and agreement on potential barriers to screening. Descriptive analysis showed significant correlation between educational attainment and knowledge of risk factors (r = 0.1381, P < 0.01). Multivariate analyses revealed that compared to Whites, Hispanics had increased odds of identifying fear of finding cancer (OR 1.56, 95% CI 1.00–2.43), language barriers (OR 4.72, 95% CI 2.62–8.50), and male physicians (OR 2.16, 95% CI 1.32–3.55) as barriers. Hispanics (OR 1.99, 95% CI 1.16–3.44) and Blacks (OR 2.06, 95% CI 1.15–3.68) had a two-fold increase in odds of agreeing that lack of knowledge was a barrier. Identified barriers varied with age, marital status and previous screening. Programs aimed at conducting free or subsidized screenings for medically underserved women should include culturally relevant education and patient care in order to reduce barriers and improve screening compliance for safety-net populations.

Highlights

Over the past four decades, there has been a steady decline in cervical cancer incidence and mortality in the United States [1,2,3]
We focus on findings from descriptive analyses of responses to questions assessing risk factor knowledge; and the role of race/ethnicity, age, and previous cervical cancer screenings to better understand these barriers
This study presents the level of awareness of cervical cancer risk factors, especially among the uninsured

Summary

Introduction

Over the past four decades, there has been a steady decline in cervical cancer incidence and mortality in the United States [1,2,3]. This decline has been largely attributed to increased uptake of cervical cancer screening tests such as Papanicolau (Pap) tests [2]. S. Preventive Task Force recommends that women between the ages of 21 and 65 obtain a Pap test every 3 years [4]. Preventive Task Force recommends that women between the ages of 21 and 65 obtain a Pap test every 3 years [4] Despite this evidence, sociodemographic disparities in screening still exist [5, 6]. Cervical cancer screening rates vary by sociodemographic factors such as race and ethnicity [6, 7], educational attainment [6,7,8], income [5, 6], health insurance [9], and immigration status [5, 7, 10]

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