Validating self-reported cervical cancer screening among women leaving jails

Abstract

Background Despite women with criminal justice involvement reporting routine Papanicolaou (Pap) testing, significant disparities in cervical cancer outcomes exist when compared to women without criminal justice involvement. A possible reason for the discrepancy is that this group of women may be misreporting Pap testing. The objective of this study was to validate self-reported cervical cancer screening among women leaving jails. Methods We used three methods to validate self-reported cervical cancer screening for women recently released from jail: 1) Medical record review; 2) Semi-structured interview; 3) Pap test knowledge survey. After validating women’s self-reported Pap tests with a review of their medical records, we scored interviews for Pap test recall, and used Pap test knowledge survey scores to compare scores between women who accurately reported Pap tests vs. those who did not. Results Sixty-one percent (N = 14/23) self-reported cervical cancer screenings were accurate per medical record review. Comparing participants who did and did not accurately self-report a Pap test, we found a significant difference in Pap test recall scores (1.90 vs. 0.00, t = 3.87, p < .01) and Pap test knowledge scores (13.50 vs. 12.13, t = 2.42, p < .05). Conclusion Self-report of cervical cancer screening was more likely to be accurate if a woman’s Pap test knowledge was high. Clinicians might take extra care in describing screening and distinguishing between Pap tests and pelvic exams to support the cervical health of women with lower knowledge.

Abnormal Pap Follow-Up among Criminal-Legal Involved Women in Three U.S. Cities

“…Another limitation is that we did not collect data from medical records to confirm abnormal results or assess the severity of dysplasia. Previous studies have found a high degree of correlation between self-reported Pap data and validated test results among criminal-legal involved women [47]. Finally, the 288-item survey takes approximately 45 minutes to complete and can be burdensome for participants.…”

Cervical Cancer Prevention in Racially Disparate Rural Populations

“…Tyler is an underserved rural area with an estimated population size of around 105,729 people [23]. Moreover, due to the lack of health literacy and related awareness, particularly among the uninsured minorities as demonstrated in other studies [24,25], limited visits could occur in the clinic for cervical health checkups. Another limitation is the lack of comprehensive follow-up data, which stemmed from the limited number of visits by the subjects.…”

Cervical cancer screening among incarcerated women

“…However, our recent pilot study assessing the relationship between women’s self-reports, medical records and a cervical health literacy score found a significant association between high literacy scores and accurate self-report. [ 24 ] This pilot was an attempt to address previous criticisms that Pap tests were potentially over-reported; the addition of a cervical health literacy assessment to future research using women’s self-report of Pap testing may improve the validity of findings.…”