Prevalence and determinants of cervical cancer screening with a combination of cytology and human papillomavirus testing

Ann Epidemiol. 2019 Aug:36:40-47. doi: 10.1016/j.annepidem.2019.06.002. Epub 2019 Jun 21.

Abstract

Purpose: In the United States, recommended options for cervical cancer screening in women aged 30 years or older include cytology alone or a combination of cytology and human papillomavirus (HPV) testing (co-testing). Although there is a body of evidence suggesting that co-testing may be the preferred screening option in this group of women, little is known about the characteristics of women who screen for cervical cancer with co-testing.

Methods: A multistage area probability design-based survey was administered to a representative sample of Texas residents. Of the 1348 female respondents, 572 women aged 30 years or older were included in this analysis. Population-weighted survey logistic regression was used to identify determinants of cervical screening with co-testing versus screening with cytology alone.

Results: Women vaccinated against HPV (aOR: 4.48, 95% CI: 1.25-15.97) or hepatitis B virus [aOR: 2.48 (1.52-4.02)], those with a personal cancer history [aOR: 2.96 (1.29-6.77)], and hormonal contraception users [aOR: 2.03 (1.03-3.97)] were more likely to be screened with co-testing than with cytology alone. Moreover, the likelihood of being screened with co-testing decreased with increasing age and decreasing annual household income.

Conclusions: Benefits and indications of co-testing should be better explained to women and health care providers.

Keywords: Cervical cancer screening; Co-testing; Cytology; HPV testing.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Cervix Uteri / pathology*
  • Colposcopy
  • Early Detection of Cancer
  • Female
  • Hormonal Contraception
  • Human papillomavirus 16 / isolation & purification*
  • Humans
  • Insurance, Health
  • Mass Screening / methods*
  • Middle Aged
  • Papanicolaou Test*
  • Papillomaviridae
  • Papillomavirus Infections / diagnosis
  • Papillomavirus Infections / epidemiology*
  • Papillomavirus Infections / virology
  • Population Surveillance
  • Prevalence
  • Surveys and Questionnaires
  • Texas
  • Uterine Cervical Neoplasms / diagnosis
  • Uterine Cervical Neoplasms / epidemiology*
  • Uterine Cervical Neoplasms / virology
  • Vaginal Smears
  • Young Adult