Variations in Cervical Cytology Testing Among Women of Different Ethnicities [29G

Abstract

INTRODUCTION: Current information about ethnic differences in the progression and regression of intraepithelial lesions on cervical cytology is undefined, with existing studies looking solely at ethnic differences in compliance with follow-up and treatment. The purpose of this study was to investigate variation in progression and regression of cervical cytology screening results among an ethnically diverse population. METHODS: A retrospective review of was conducted for women receiving cervical cytology evaluation from January 1, 2006 through September 30, 2015. Differences in intraepithelial lesion diagnoses on cervical cytology for patients were reviewed. We fit Markov multi-state models to estimate self-reported race/ethnicity-specific expected wait times and hazard rates for each possible regression and progression, and compared a model with race to an intercept-only model using a chi-square likelihood ratio test. RESULTS: The sample consisted of 7635 patients, with mean baseline age 34±12, and was 31% Hispanic, 26% White, 17% Black, and 9% Asian, Middle Eastern or other. We estimated a total of 24 hazard ratios and 95% confidence intervals comparing rates of transition to and from ASCUS, ASCH, LGSIL, and HGSIL, for the race/ethnicity categories of Black, Hispanic, and a category for Asian, Middle Eastern, or other, compared to White. The model including race fit significantly better than the intercept-only model (p < 0.001). Visual inspection of expected wait time curves indicated that Black and Hispanic women had a slower progression as well as a slower regression. CONCLUSION: Preliminary analysis suggests that the progression/regression of precancerous lesions on cervical cytology may behave differently among women of different ethnicities.