Correlates of premature pap test screening, under 25 years old: analysis of data from the CONSTANCES cohort study

Abstract

Background Many countries currently recommend that screening for cervical cancer begin at the age of 25 years. Premature screening (before that age) could lead to unnecessary follow-up examinations and procedures that turn out to be useless. Our objective is to ascertain if the use of particular contraceptive methods are associated with premature screening. Methods This cross-sectional study based on the CONSTANCES cohort enabled us to include 4297 women younger than 25 years. The factors associated with premature screening were modeled by logistic regression. Missing data were handled by multiple imputations. The multivariate analyses were adjusted for sex life, social and demographic characteristics, and health status. Results Nearly half (48.5%) the women younger than 25 years had already undergone premature screening. Women not using contraceptives (aOR 0.3, 95% CI 0.3–0.5) and those using nonmedicalized contraceptives (condom, spermicide, etc.) (aOR 0.5, 95% CI 0.4–0.6) had premature screening less often than women using birth control pills. Higher risks of premature screening were observed in 20-year-old women (aOR 2.7, 95% CI 2.2–3.3) and in those with more than 5 lifetime partners (aOR 2.5, 95% CI 2.0–3.1), compared respectively with women who were younger and those with 5 or fewer lifetime partners. Conclusion Young women using contraceptives that require a doctor’s prescription are exposed to premature screening more often than those not using contraception and those with nonmedicalized contraceptives.

Factors associated with shorter-interval cervical cancer screening for young women in three United States healthcare systems

“…There will likely be additional changes to screening guidelines for women in this age group in the coming years. While several studies have examined effects of the 2012 guideline change on screening practices and patient factors associated with guideline-concordant screening ( Castle et al, 2021 , Parekh et al, 2017 , Mignot et al, 2021 , Qin et al, 2021 , Silver et al, 2018 ), few studies have evaluated the effect of providers and health systems on adoption of new guidelines. Understanding the patient, provider, and health system characteristics associated with variation in the adoption of new recommendations may aid in designing interventions to implement new guidelines for this age group in the future.…”