Race and Ethnic Disparities in Cervical Cancer Screening in a Safety-Net System

Owusu, Adobea Yaa; Eve, Susan Brown; Cready, Cynthia M.; Koelln, Kenneth; Trevino, Fernando M.; Urrutia-Rojas, Ximena; Baumer, Joanne

doi:10.1007/s10995-005-0004-8

Cited by 43 publications

(30 citation statements)

References 22 publications

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“…42 Cervical cancer screening rates for women from minority groups are consistently below the rates of nonminority women. [43][44][45] Using data for self-reported Pap screening behavior from the Behavioral Risk Factor Surveillance System (BRFSS), Coughlin et al 46 found that women from minority racial=ethnic groups, lower education level, and lower income or the unemployed were less likely to participate in screening.…”

Section: Discussionmentioning

confidence: 99%

Barriers to Cervical Cancer Screening Among Lesbians

Tracy

Lydecker

Ireland

2010

Journal of Women's Health

105

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Objective: To evaluate cervical cancer screening practices and barriers to screening in a sample of lesbians. Methods: Cross-sectional survey data were collected from 225 self-identified lesbians who completed an online questionnaire. Results: Of the respondents, 71% reported receiving a Pap screening test in the past 24 months (routine screeners), and 29% reported receiving a Pap screening test >24 months ago or never (nonroutine screeners). Routine screeners were more likely to be older ( p < 0.01), white ( p ¼ 0.04), and college graduates ( p < 0.01) than nonroutine screeners. Nonroutine screeners were more likely to delay seeking healthcare because of fear of discrimination ( p < 0.01) and were less likely than routine screeners to disclose orientation to their primary care physician ( p < 0.01). After adjusting for age, race, and education, nonroutine screeners perceived fewer benefits from ( p < 0.01) and more barriers ( p < 0.01) to Pap screening tests and were less knowledgeable about screening guidelines ( p < 0.01) than routine screeners, but there was no difference in perceived susceptibility ( p ¼ 0.68), perceived seriousness ( p ¼ 0.68), or risk factor knowledge ( p ¼ 0.35) of cervical cancer. Conclusions: Many lesbians do not screen for cervical cancer at recommended rates. Nonroutine screeners perceive fewer benefits, more barriers, and more discrimination and are less knowledgeable about screening guidelines than routine screeners.

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Section: Discussionmentioning

confidence: 99%

Barriers to Cervical Cancer Screening Among Lesbians

Tracy

Lydecker

Ireland

2010

Journal of Women's Health

105

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“…24 Studies focusing on minority racial/ethnic populations indicate that lack of health insurance, lower level of education, lack of continuity of care, and lower use of public services were associated with lack of adherence to annual Pap smears. [25][26][27] Unfortunately, we did not have data to assess income, employment, or education. All of our patients were either insured or were eligible to receive primary and gynecological care paid by the Ryan White CARE Act support, which does not require an enrollment wait time or other special procedure in our region, so insurance was not likely a barrier in this study.…”

Section: Discussionmentioning

confidence: 99%

HIV Women's Health: A Study of Gynecological Healthcare Service Utilization in a U.S. Urban Clinic Population

Tello

Yeh

Keller

et al. 2008

Journal of Women's Health

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Background: Women infected with HIV have a high rate of many gynecological problems. Adherence to recommended gynecological care among women enrolled in our urban HIV clinics was hypothesized to be low. Conclusions: This analysis determined that the rate of clinic visit adherence is significantly lower for HIV gynecological care than for HIV primary care in the same population of women. Factors associated with HIV gynecological clinic visit noncompliance included African American race/ethnicity, substance use, and more advanced immunosuppression. We have planned additional quantitative and qualitative studies to examine the associations with and barriers to HIV gynecological care, with the goal of creating appropriate interventions toward improving gynecological healthcare utilization among women enrolled in urban HIV clinics.

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“…43 Two studies focused on Pap smears for immigrant patients using telephone surveys concluded that awareness of a safety net systems and culturally competent-based care also is needed to improve quality of care among minority groups. 44,45 CONCLUSION This is one of the first studies to have attempted to address the role of a system of care on reducing ethnic disparities in health care. The IOM report on "Unequal Treatment" underscored the need for such studies.…”

Section: Discussionmentioning

confidence: 99%

Can America’s Urban Safety Net Systems be a Solution to Unequal Treatment?

2008

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Eliminating disparities in care for racial and ethnic minorities remains a challenge in achieving overall quality health care. One approach to resolving issues of inequity involves utilizing an urban safety-net system to address preventive and chronic care disparities. An analysis was undertaken at Denver Health (DH), an urban safety net which serves 150,000 patients annually, of which 78% are minorities and 50% uninsured. Medical charts for 4,795 randomly selected adult patients at ten DHassociated community health centers were reviewed between July 1999 and December 2001. Logistic regression was used to identify differences between racial/ethnic groups in cancer screening, blood pressure control, and diabetes management. No disparities in care were found, and in most instances, the quality of care met or exceeded available benchmarks, leading us to conclude that treatment in urban integrated safety net systems committed to caring for minority populations may represent one approach to reducing disparity.

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Race and Ethnic Disparities in Cervical Cancer Screening in a Safety-Net System

Abstract: Culturally competent, community-based care for women is needed to increase Pap smear screening among minority groups, especially Hispanic immigrant and Hispanic American women.

Cited by 43 publications

References 22 publications

Barriers to Cervical Cancer Screening Among Lesbians

Barriers to Cervical Cancer Screening Among Lesbians

HIV Women's Health: A Study of Gynecological Healthcare Service Utilization in a U.S. Urban Clinic Population

Can America’s Urban Safety Net Systems be a Solution to Unequal Treatment?

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