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Factors associated with high-risk human papillomavirus test utilization and infection: a population-based study of uninsured and underinsured women

BACKGROUND: Current cervical cancer screening guidelines recommend a Pap test every 3 years for women age 21–65 years, or for women 30–65 years who want to lengthen the screening interval, a combination of Pap test and high-risk human papilloma virus testing (co-testing) every 5 years. Little popula...

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Autores principales: Llanos, Adana A. M., Tsui, Jennifer, Rotter, David, Toler, Lindsey, Stroup, Antoinette M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6171187/
https://www.ncbi.nlm.nih.gov/pubmed/30285820
http://dx.doi.org/10.1186/s12905-018-0656-3
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author Llanos, Adana A. M.
Tsui, Jennifer
Rotter, David
Toler, Lindsey
Stroup, Antoinette M.
author_facet Llanos, Adana A. M.
Tsui, Jennifer
Rotter, David
Toler, Lindsey
Stroup, Antoinette M.
author_sort Llanos, Adana A. M.
collection PubMed
description BACKGROUND: Current cervical cancer screening guidelines recommend a Pap test every 3 years for women age 21–65 years, or for women 30–65 years who want to lengthen the screening interval, a combination of Pap test and high-risk human papilloma virus testing (co-testing) every 5 years. Little population-based data are available on human papilloma virus test utilization and human papilloma virus infection rates. The objective of this study was to examine the patient-level, cervical cancer screening, and area-level factors associated with human papilloma virus testing and infection among a diverse sample of uninsured and underinsured women enrolled in the New Jersey Cancer Early Education and Detection (NJCEED) Program. METHODS: We used data for a sample of 50,510 uninsured/underinsured women, age ≥ 29 years, who screened for cervical cancer through NJCEED between January 1, 2009 and December 31, 2015. Multivariable logistic regression models were used to estimate associations between ever having a human papilloma virus test or a positive test result, and individual- (age, race/ethnicity, birthplace) and area-level covariates (% below federal poverty level, % minority, % uninsured), and number of screening visits. RESULTS: Only 26.6% (13,440) of the sample had at least one human papilloma virus test. Among women who underwent testing, 13.3% (1792) tested positive for human papilloma virus. Most women who were positive for human papilloma virus (99.4%) had their first test as a co-test. Human papilloma virus test utilization and infection were significantly associated with age, race/ethnicity, birthplace (country), and residential area-level poverty. Rates of human papilloma virus testing and infection also differed significantly across counties in the state of New Jersey. CONCLUSIONS: These findings suggest that despite access to no-cost cervical cancer screening for eligible women, human papilloma virus test utilization was relatively low among diverse, uninsured and underinsured women in New Jersey, and test utilization and infection were associated with individual-level and area-level factors.
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spelling pubmed-61711872018-10-10 Factors associated with high-risk human papillomavirus test utilization and infection: a population-based study of uninsured and underinsured women Llanos, Adana A. M. Tsui, Jennifer Rotter, David Toler, Lindsey Stroup, Antoinette M. BMC Womens Health Research Article BACKGROUND: Current cervical cancer screening guidelines recommend a Pap test every 3 years for women age 21–65 years, or for women 30–65 years who want to lengthen the screening interval, a combination of Pap test and high-risk human papilloma virus testing (co-testing) every 5 years. Little population-based data are available on human papilloma virus test utilization and human papilloma virus infection rates. The objective of this study was to examine the patient-level, cervical cancer screening, and area-level factors associated with human papilloma virus testing and infection among a diverse sample of uninsured and underinsured women enrolled in the New Jersey Cancer Early Education and Detection (NJCEED) Program. METHODS: We used data for a sample of 50,510 uninsured/underinsured women, age ≥ 29 years, who screened for cervical cancer through NJCEED between January 1, 2009 and December 31, 2015. Multivariable logistic regression models were used to estimate associations between ever having a human papilloma virus test or a positive test result, and individual- (age, race/ethnicity, birthplace) and area-level covariates (% below federal poverty level, % minority, % uninsured), and number of screening visits. RESULTS: Only 26.6% (13,440) of the sample had at least one human papilloma virus test. Among women who underwent testing, 13.3% (1792) tested positive for human papilloma virus. Most women who were positive for human papilloma virus (99.4%) had their first test as a co-test. Human papilloma virus test utilization and infection were significantly associated with age, race/ethnicity, birthplace (country), and residential area-level poverty. Rates of human papilloma virus testing and infection also differed significantly across counties in the state of New Jersey. CONCLUSIONS: These findings suggest that despite access to no-cost cervical cancer screening for eligible women, human papilloma virus test utilization was relatively low among diverse, uninsured and underinsured women in New Jersey, and test utilization and infection were associated with individual-level and area-level factors. BioMed Central 2018-10-03 /pmc/articles/PMC6171187/ /pubmed/30285820 http://dx.doi.org/10.1186/s12905-018-0656-3 Text en © The Author(s). 2018 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Llanos, Adana A. M.
Tsui, Jennifer
Rotter, David
Toler, Lindsey
Stroup, Antoinette M.
Factors associated with high-risk human papillomavirus test utilization and infection: a population-based study of uninsured and underinsured women
title Factors associated with high-risk human papillomavirus test utilization and infection: a population-based study of uninsured and underinsured women
title_full Factors associated with high-risk human papillomavirus test utilization and infection: a population-based study of uninsured and underinsured women
title_fullStr Factors associated with high-risk human papillomavirus test utilization and infection: a population-based study of uninsured and underinsured women
title_full_unstemmed Factors associated with high-risk human papillomavirus test utilization and infection: a population-based study of uninsured and underinsured women
title_short Factors associated with high-risk human papillomavirus test utilization and infection: a population-based study of uninsured and underinsured women
title_sort factors associated with high-risk human papillomavirus test utilization and infection: a population-based study of uninsured and underinsured women
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6171187/
https://www.ncbi.nlm.nih.gov/pubmed/30285820
http://dx.doi.org/10.1186/s12905-018-0656-3
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