Access of Black, Hispanic, and Nonprivately Insured Women to Liquid-Based Cytology, Human Papillomavirus DNA Testing, and On-Site Colposcopy in the United States
| Autor: | Danuta Kasprzyk, April Greek, Nidhi Jain, Daniel E. Montaño, Emilia H. Koumans, Karen W. Hoover, Kathleen L. Irwin, Crystal Freeman |
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| Rok vydání: | 2009 |
| Předmět: |
Male
medicine.medical_specialty Ethnic group Dna testing Cervical cancer screening Health Services Accessibility Cytology medicine Human papillomavirus DNA Humans Mass Screening Vaginal Smears Colposcopy Gynecology medicine.diagnostic_test business.industry Papillomavirus Infections DNA Viruses Obstetrics and Gynecology Cell Biology Hispanic or Latino General Medicine Middle Aged United States Black or African American Family medicine Liquid-based cytology Insurance status Female business |
| Zdroj: | Journal of Lower Genital Tract Disease. 13:17-27 |
| ISSN: | 1089-2591 |
| Popis: | To determine whether patient race, ethnicity, or insurance status was associated with access to cervical cancer screening with liquid-based cytology (LBC) and with human papillomavirus (HPV) DNA testing and with access to on-site colposcopy at the provider's principal practice site.We conducted a nationally representative survey of clinicians in specialties that provide cervical cancer screening. Adjusted odds ratios (OR) were estimated for the associations between race, ethnicity, and insurance status of patients and provider use of LBC, HPV DNA testing, and on-site colposcopy.Providers who cared foror=20% Hispanic patients were less likely to use LBC (OR 0.60, 95% CI=0.42-0.84). Providers who cared foror=25% black women (OR 0.71, 95% CI=0.51-0.98) and providers who cared for75% privately insured patients (OR 0.66, 95% CI=0.46-0.95) were less likely to use HPV DNA testing. Providers who cared for75% privately insured patients were less likely to have on-site colposcopy (OR 0.57, 95% CI=0.37-0.89), but those who cared foror=20% Medicaid patients were more likely to have on-site colposcopy (OR 1.86, 95% CI=1.26-2.73).Given the high rates of cervical cancer in minority women, access to cervical cancer screening and diagnostic follow-up must be ensured. It may also be beneficial to ensure affordable access to technologies such HPV DNA testing that increases the sensitivity of disease detection and to on-site colposcopy that facilitates follow-up of abnormal cytology. |
| Databáze: | OpenAIRE |
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