 | The 131st Annual Meeting (November 15-19, 2003) of APHA |
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| The 131st Annual Meeting (November 15-19, 2003) of APHA |
Claudia Hopenhayn, MPH, PhD, Bin Huang, MS, Todd Jenkins, MPH, Angel Rubio, MA, Nancy Shoenberg, PhD, Evelyn Knight, PhD, Joyce Beaulieu, MPH, PhD, and Amy Christian, MSPH. School of Public Health and Cancer Control Program, University of Kentucky, 2365 Harrodsburg Road, Suite B150, Lexington, KY 40504-3381, 859-296-6630 ext. 229, cmhope0@uky.edu
The widespread use of the Pap test has substantially reduced the burden of invasive cervical cancer (ICC). However, the incidence rates of ICC in the Appalachian region of Kentucky (AKY) remain among the highest nationwide. The main causes have not been clearly identified, but are likely a combination of low screening, inadequate follow-up of abnormal Paps, and high risk factors (smoking rates among AKY women are 40% higher than the national average for women). Identification of the main factors underlying these causes at the local level, based on cultural and socioeconomic characteristics and health care utilization patterns, followed by appropriately tailored intervention programs, will aid in reducing the ICC burden. Our long-term objective is to develop interventions to reduce ICC by working at the local level. Under a grant funded jointly by the Appalachian Regional Commission and the Centers for Disease Control and Prevention (CDC), we will pilot an intervention program in one AKY county. Our first task is to prioritize the 51 AKY counties. This presentation will describe the methodology employed to identify and rank AKY counties by ICC high-risk/high-burden status, combining ICC incidence data, socioeconomic indicators and county-specific utilization of CDC’s cervical cancer screening program. Given the large number of small counties in AKY, county-level incidence rates are statistically unstable, even after 5-year aggregation. We utilized a population-weighted statistical smoothing algorithm to overcome this limitation, identifying the patterns of highest ICC rates within AKY. We will present the stepwise approach and the results of this prioritization analysis.
Learning Objectives:
Keywords: Cervical Cancer,
Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.