2015 APHA Annual Meeting & Expo

Home Events & Meetings Annual Meeting Schedule & Program

Recorded Annual Meeting Presentations (RAMP) are now available for purchase.
Only $90 for presenters, $140 for registered attendees and $200 for non-attendees.

Online Program

322035
Cervical cancer screening among women over 70 years of age in the US, NHIS 2013 – provider recommendation or patient choice?


Wednesday, November 4, 2015 : 10:30 a.m. - 10:50 a.m.

Fangjian Guo, MD, PhD, Department of Obstetrics & Gynecology, and Center for Interdisciplinary Research in Women’s Health, University of Texas Medical Branch, Galveston, TX
Jacqueline Hirth, PhD, MPH, Department of Obstetrics & Gynecology, and Center for Interdisciplinary Research in Women’s Health, University of Texas Medical Branch, Galveston, TX
Abbey Berenson, MD, PhD, MMS, Department of Obstetrics & Gynecology, and Center for Interdisciplinary Research in Women’s Health, University of Texas Medical Branch, Galveston, TX
Audio (mp3) recording Recorded Presentation (mp4)
Background: The US Preventive Services Task Force (USPSTF) guidelines only recommend routine cervical cancer screening in women 21-65 years old. However, cervical cancer screening is common among older US women (65+ years), even among those with <5-year life expectancy, according to National Health Interview Survey (NHIS) 2000-2010. This study assessed characteristics and potential causes of cervical cancer screening among US women (70+ years).

Methods: This is a cross-sectional study on 1752 female participants (70+ years) with valid information on most recent Pap smear (self-reported), no history of hysterectomy, no history of cervical cancer, and having screening not due to a problem from NHIS 2013. We assessed doctor’s recommendations for cervical cancer screening in the past 12 months and Pap smear uptake.

Results: Among 1752 US women (70+ years old), 40.8% had a Pap test within the last 3 years, 19.4% had a Pap test in the past 12 months, and 39.7% received recommendations for Pap smears from doctors in the past 12 months. Among women who received doctors’ recommendations, 39.8% had a Pap test in the past 12 months, while among those who did not receive recommendations, only 5.9% had a Pap test (adjusted odds ratio 9.03, 95% CI 6.19-13.2).

Conclusions: Cervical cancer screening is common among older US women, largely due to referrals than patient choice. This study indicates that health providers may be encouraging overutilization of cervical cancer screening among older adults. Health care providers should refrain from recommending screening to a population unlikely to benefit from this test.

Learning Areas:

Chronic disease management and prevention
Public health or related laws, regulations, standards, or guidelines
Public health or related research
Social and behavioral sciences

Learning Objectives:
Describe the current situation of cervical cancer screening among older women in the United States. Identify the causes for overutilization of cervical cancer screening among older women in the United States.

Keyword(s): Cancer Prevention and Screening, Women's Health

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am an expert on Epidemiology and Statistics, and secondary data analysis. I am familiar with National Health Interview Survey and the analytic guidelines, and I performed data analysis for this study and drafted the abstract. My current research interests include cancer screening and prevention.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 5127.0: Chronic Disease Screening and Prevention