Characterizing cervical cancer screening and barriers to care among U.S. women - an All of Us Research Program study

Document Type

Conference Proceeding

Publication Date

7-1-2024

Publication Title

J Low Genit Tract Dis

Abstract

Objective: Using a large, racially and ethnically diverse database, we sought tocharacterize cervical cancer screening practices and identify factors associatedwith lack of screening.Methods: The All of Us database developed by the NIH was utilized to assesscervical cancer screening practices among non-Hispanic White (NHW), Hispanic and Black women. HPV test results and ICD-10 codes abstracted fromelectronic health records were used to assess cervical cancer screening practices.Census and survey data were used to assess objective and patient-reported measures of socioeconomic deprivation.Results: We included 203,250 patients age 21 or older, of whom only 10% underwent any form of HPV screening. Hispanic women had significantly lower rates of HPV screening, with only 8% having ever been screened compared to 11% of NHWwomen. Among those who did not undergo screening, Hispanic and Black women were more likely than their NHW counterparts to have no health insurance, lowerlevels of education or to be unemployed/unable to work. Hispanic women who were not screened were more likely to report unstable housing, or lack of transportation,childcare, or sufficient time off work as barriers to seeking medical care. Finally,6% of Hispanic women who were screened for HPV were inappropriatelyscreened per ASCCP guidelines compared to 4% of screened NHW women.Conclusions: Examination of the All of Us database revealed significantunderscreening for HPV and cervical dysplasia. Both the absence of screening and deviation from guideline concordant screening directly correlate with important social drivers of health.

Volume

28

Issue

3

First Page

S18

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