142nd APHA Annual Meeting and Exposition

Annual Meeting Recordings are now available for purchase

305521
Abnormal Pap smear management among migrant farm workers in New York

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Tuesday, November 18, 2014

Emory Prochoda , School of Natural Sciences, Hampshire College, Amherst, MA
Elizabeth Conlisk, Ph.D. , School of Natural Sciences, Hampshire College, Amherst, MA
Miriam Cremer, MD, MPH , Obstetrics and Gynecology, University of Pittsburgh, Pittsburgh, PA
Joan Combellic
Ayana April
Emma Marquez
Objective: This study examined whether female migrant farm workers with an abnormal Pap smear received appropriate follow-up.

Methods: The sample included women who had had an abnormal Pap smear (ASC-US, LSIL, HSIL) at a migrant health clinic in upstate New York in 2009.  Data were extracted from the clinic’s medical charts in 2011.  In addition to the Pap result and follow-up, information was collected on age, pregnancy status, insurance coverage and first language.  Appropriate follow-up was defined using the American Congress of Obstetricians and Gynecologists (ACOG) guidelines for management of abnormal Paps: 1) HPV testing for women with ASC-US or LSIL, with follow-up colposcopy for those HPV-positive and a repeat Pap for those HPV-negative; 2) colposcopy for all women with HSIL. Relative risks were computed to identify factors associated with appropriate follow-up (p < 0.05).

Results: 153 women, age 15 to 61, were found to have had an abnormal Pap. ASC-US, LSIL, and HSIL accounted for 65%, 24%, and 10% of the Pap smear abnormalities, respectively.  97 women (63%) did not receive ACOG-recommended follow-up: 69% of women with ASC-US; 58% of women with LSIL and 40% of women with HSIL. None of the variables tested (age, pregnancy status, insurance coverage and language) significantly predicted appropriate follow-up, perhaps due to small sample size.

Conclusions: In this sample, 63% of female migrant farm workers with abnormal Paps had no record of appropriate follow-up, though some could have received care elsewhere.  More research is needed to understand the breakdown in referral and follow-up processes.

Learning Areas:

Administer health education strategies, interventions and programs
Basic medical science applied in public health
Planning of health education strategies, interventions, and programs

Learning Objectives:
Identify whether migrant farm workers with abnormal Pap smears are receiving the American Congress of Obstetricians and Gynecologists recommended follow-up.

Keyword(s): Cancer Prevention and Screening, Adherence

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am an undergraduate studying public health and have no conflicts of interest to report. My scientific interests have been focused on HPV prevention, follow-up in abnormal Pap smears, and international women's health.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.