Abstract
BackgroundThe Canadian circumpolar Inuit population has a higher incidence rate of cervical cancer than the general population and the majority of cases occur among underscreened women. The objectives of this study were to determine Pap smear utilization rates and to determine factors associated with time-inappropriate use of cervical cancer screening among a cohort of Inuit women from Nunavik, Quebec, Canada.MethodsThis study utilizes baseline information collected from a cohort formed between January 2002 and December 2007 to study the natural history of HPV among Inuit women aged 21–69 years in Nunavik, Quebec. Cervical cancer screening history and other variables were obtained from a baseline questionnaire and medical chart review. Unconditional logistic regression was used to estimate the odds ratios and 95% confidence intervals for potential predictors of not having a Pap smear within the previous 3 years prior to cohort entry.ResultsA total of 403 Inuit women who had a baseline questionnaire and chart review were included. The mean age of the study population was 34.2 years. In the three years prior to study entry, 25% of women did not have a Pap smear. Older age and never giving birth were significant predictors of time-inappropriate Pap smear use.ConclusionsOur results suggest that older women and women who are not accessing reproductive care have a lower compliance with time-appropriate cervical cancer screening and future research should address potential strategies to increase screening coverage among this group.
Highlights
The Canadian circumpolar Inuit population has a higher incidence rate of cervical cancer than the general population and the majority of cases occur among underscreened women
This analysis utilizes baseline questionnaire and retrospective chart review data collected on a cohort of Inuit women, which was created to examine the natural history of human papillomavirus (HPV) in Nunavik [12,19,20]
The highest rate of time inappropriate Pap smear use by age group was seen among women aged 45 and older (29.8%), followed by women aged 30 to 44 years (27.5%)
Summary
The Canadian circumpolar Inuit population has a higher incidence rate of cervical cancer than the general population and the majority of cases occur among underscreened women. The objectives of this study were to determine Pap smear utilization rates and to determine factors associated with time-inappropriate use of cervical cancer screening among a cohort of Inuit women from Nunavik, Quebec, Canada. As women visit the community clinic for any reason staff will review their charts and offer cervical cancer screening if there is no history of Pap smear within the past year. In association with a study on the natural history of HPV among Inuit women, members of the research team conducted health promotion activities around cervical cancer screening on the local radio three times per year during study recruitment and follow-up. Screening and treatment of cervical cancer is available at no charge under the provincial health insurance plan (Régie de l’assurance maladie du Québec)
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