Cervical screening uptake in ethnic minority women

Abstract

Pap smear screenings have increased greatly in the past 10 years, but not among many ethnic minority women. Asian, African-American, and Latina women still face barriers to obtaining regular screenings and early treatment for cervical cancer in the USA. A series of studies has documented the reasons why many ethnic minority women do not get Pap smears or return for follow-up screenings. The researchers have also proposed some unique solutions, including streamlined office visits, and the use of lay health workers, who work one-on-one with these patients. In an unpublished study of 376 Latina women and 66 non-Latinas at a community health clinic near Los Angeles, researchers from the University of California (Irvine, CA, USA) found that Latina women were much less likely to know what do after their doctor finds an abnormal Pap smear, much less likely to believe that cervical cancer was curable, and less likely to return for further treatment after an abnormal Pap smear. Nearly 40% of Latinas who had abnormal Pap smears did not return for treatment, according to the study, presented at the annual American Public Health Association Meeting (21–25 October 2001, Atlanta, GA, USA). The researchers proposed that the usual three to four consultations for Pap smear screening, follow-up, and treatment be compressed into one. Says lead researcher Alberto Manetta, Professor of Gynecologic Oncology at the University of California, “One visit would be much more acceptable and feasible for these women, and more likely to increase follow-up screenings”. In another recent study of cervical and breast cancer screening practices, researchers at the Northern California Cancer Center (Union City, CA, USA) surveyed 1600 Latina, Asian, AfricanAmerican, and white women in low income neighbourhoods in the San Francisco area from 1993 to 1996 (Prev Med 2001; 33: 190–203). They found that Pap smear screening rates were lowest among non-English speaking Latinas (72%) and non-English speaking Chinese women (24%). Many of the women were not aware of the importance of Pap smears, because of problems in communicating with doctors and the limited access to smear tests in their native country. In a second part of the study, the researchers assigned lay health workers to contact and follow-up on more than 2000 low income and ethnic minority women. Though the results have not yet been published, the researchers report that in the subset of women reached by the intervention, substantial increases in uptake of Pap smear screenings were found among the Chinese and Latina women. Says researcher Rena Pasick, Director of Prevention Sciences at the Northern California Cancer Center, “A woman to woman approach for educating women in their communities is critical in creating a commitment to lifelong screening”. Barbara Boughton