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APHA Scientific Session and Event Listing

Katherine Eggleston¹, Ann L. Coker, PhD¹, Kathryn Luchok, PhD², and Tamra E. Meyer, MPH¹. (1) University of Texas at Houston School of Public Health, 1200 Herman Pressler, Houston, TX 77030, 713-500-9954, Katherine.S.Eggleston@uth.tmc.edu, (2) Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, 800 Sumter Street, Columbia, SC 29208

Background: African-American women have higher cervical cancer incidence and mortality rates when compared with non-Hispanic White women. Reasons for this disparity may include differences in receiving timely follow-up care after an abnormal Pap test. Setting: Women receiving cervical cancer screening from the National Breast and Cervical Cancer Early Detection Program (NBCCEDP) in South Carolina were invited to participate in this study. Participants: Eligible subjects included women aged 47-64 who received a referral for follow-up care after an abnormal Pap test from 1999-2002 in South Carolina (n=330). All were uninsured, low income women receiving free or reduced care through the NBCCEDP. Main Outcome: Adherence to follow-up care was measured as days to receipt of follow-up care after an abnormal Pap test. Cox proportional hazards modeling was used to model time to adherence at within the recommended 60 days and within 365 days. Results: African-American and non-Hispanic White women had similar adherence to follow-up. Among White women, those with high grade lesions were less likely to adhere relative to those with low grade lesions. For African-American women, rural residence and history of abnormal pap tests were associated with decreased adherence, whereas education and socioeconomic status were associated with increased adherence. Conclusions: Adherence rates did not differ by race. However, risk factors for adherence within race were variable. Interventions addressing timely adherence to follow-up care after an abnormal Pap smear should be culturally sensitive and address the differential needs of racial and ethnic groups.

Learning Objectives: At the conclusion of the session, the participant will be able to

• Identify factors shown to be associated with lack of adherence to cancer screening and follow-up recommendations.
• Evaluate whether adherence rates to follow-up care after an abnormal Pap test differ by race.
• Describe necessary components of interventions needed to address timely adherence to follow-up care after an abnormal Pap smear across different racial and ethnic groups.

Presenting author's disclosure statement:

Not Answered