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Persistent Disparities in Pap Test Use: Assessments and Predictions for Asian Women in the U.S., 1982–2010

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Abstract

Disparities in cancer screening among U.S. women are well documented. However, little is known about Pap test use by Asian women living in the U.S. Data for women, ages 18 and older, living in the U.S. were obtained from National Health Interview Survey (NHIS) files from 1982 to 2005. Outcomes were ever having a Pap test and having a Pap test within the preceding 3 years. Pap test prevalence trends were estimated by race and ethnicity and for Asian subgroups. Fractional logit models were used to predict Pap test use in 2010. Although the rate of having a Pap test within the preceding 3 years increased slightly from 1982 to 2005 for all U.S. women, Asian women continue to have the lowest rate. Pap test use also varied within Asian subpopulations living in the U.S. None of the races and ethnicities are predicted to reach the Pap test targets of Healthy People 2010. To reduce or eliminate continuing disparities in Pap test use requires targeted policy interventions.

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References

  1. World Health Organization. Comprehensive cervical cancer control: a guide to essential practice. Geneva, Switzerland: WHO Press; 2006.

    Google Scholar 

  2. Parkin DM, Bray F. Chapter 2: the burden of HPV-related cancers. Vaccine. 2006;24S3:S3/11–25.

    Google Scholar 

  3. National Cancer Institute. Cervical cancer. http://www.cancer.gov/cancertopics/types/cervical/. Accessed March 29, 2009.

  4. Schiffman M, Castle PE. The promise of global cervical-cancer prevention. N Engl J Med. 2005;353:2101–4.

    Article  CAS  PubMed  Google Scholar 

  5. American Cancer Society. Cervical cancer: prevention and early detection. http://www.cancer.org/docroot/CRI/content/CRI_2_6x_cervical_cancer_prevention_and_early_detection_8.asp?sitearea=PED. Accessed November 30, 2008.

  6. National Cancer Institute. Cervical cancer screening. http://progressreport.cancer.gov/doc_detail.asp?pid=1&did=2007&chid=72&coid=717&mid=#benefits. Accessed November 30, 2008.

  7. U.S. Department of Health and Human Services. Healthy People 2010: volume I. 2nd ed. Washington, DC: U.S. Government Printing Office, November 2000. http://www.healthypeople.gov/Document/tableofcontents.htm#volume1. Accessed February 8, 2009.

  8. Mills PK, Yang RC, Riordan D. Cancer incidence in the Hmong in California, 1998–2000. Cancer. 2005;104(12 Suppl):2969–74.

    Article  PubMed  Google Scholar 

  9. Saraiya M, Ahmed F, Krishnan S, et al. Cervical cancer incidence in a prevaccine era in the United States, 1998–2002. Obstet Gynecol. 2007;109:360–70.

    PubMed  Google Scholar 

  10. McCracken M, Olsen M, Chen MS, et al. Cancer incidence, mortality, and associated risk factors among Asian Americans of Chinese, Filipino, Vietnamese, Korean, and Japanese Ethnicities. CA Cancer J Clin. 2007;57:190–205.

    Article  PubMed  Google Scholar 

  11. Jemal A, Murray T, Ward E, et al. Cancer statistics. CA Cancer J Clin. 2005;55:10–30.

    Article  PubMed  Google Scholar 

  12. Jemal A, Siegel R, Ward E, et al. Cancer statistics. CA Cancer J Clin. 2007;57:43–66.

    Article  PubMed  Google Scholar 

  13. Miller BA, Kolonel LN, Bernstein L, et al., editors. Racial/ethnic patterns of cancer in the United States 1988–1992. NIH Pub. No. 96-4104. Bethesda: National Cancer Institute; 1996.

  14. Yang RC, Mills PK, Riordan DG. Cervical Cancer Among Hmong women in California, 1998–2000. Am J Prev Med. 2004;27:132–8.

    Article  PubMed  Google Scholar 

  15. De Alba I, Ngo-Metzger Q, Sweningson JM, et al. Pap smear use in California: are we closing the racial/ethnic gap? Prev Med. 2005;40:747–55.

    Article  PubMed  Google Scholar 

  16. Keppel KG. Ten largest racial and ethnic health disparities in the United States based on Healthy People 2010 objectives. Am J Epidemiol. 2007;166:97–103.

    Article  PubMed  Google Scholar 

  17. Kagawa-Singer M, Wong L, Shostak S, et al. Breast and cervical cancer screening practices for low-income Asian American women in ethnic-specific clinics. Californian J Health Promot. 2005;3:180–92.

    Google Scholar 

  18. Chaudhry S, Fink A, Gelberg L, et al. Utilization of papanicolaou smears by south Asian women living in the United States. J Gen Intern Med. 2003;18:377–84.

    Article  PubMed  Google Scholar 

  19. Hiatt RA, Pasick RJ, Stewart S, et al. Community-based cancer screening for underserved women: design and baseline findings from the breast and cervical cancer intervention study. Prev Med. 2001;33:190–203.

    Article  CAS  PubMed  Google Scholar 

  20. Solomon D, Breen N, McNeel T. Cervical cancer screening rates in the United States and the potential impact of implementation of screening guideline. CA Cancer J Clin. 2007;57:105–11.

    Article  PubMed  Google Scholar 

  21. Johnson PJ, Blewett LA, Ruggles S, et al. Four decades of population health data: the Integrated Health Interview Series. Epidemiology. 2008;19(6):872–5.

    Article  PubMed  Google Scholar 

  22. Minnesota Population Center and State Health Access Data Assistance Center, Integrated Health Interview Series: Version 1.0. http://www.ihis.us. Accessed November 30, 2008.

  23. Integrated Health Interview Series. Link NHIS public use files to IHIS data. http://www.ihis.us/ihis/userNotes_links.shtml. Accessed November 30, 2008.

  24. Office of Management and Budget. Provisional guidance on the implementation of the 1997 standards for the collection of Federal data on race and ethnicity. http://www.ofm.wa.gov/pop/race/omb.pdf. Accessed November 30, 2008.

  25. StataCorp. Stata statistical software; release 10. College Station: StataCorp LP; 2007.

    Google Scholar 

  26. StataCorp. Survey data reference manual. College Station: Stata Press; 2007.

    Google Scholar 

  27. Parke L, Wooldridge JM. Econometric methods for fractional response variables with an application to 401(K) plan participation rates. J Appl Econ. 1996;11:619–32.

    Article  Google Scholar 

  28. Chen MS. Cancer health disparities among Asian Americans: what we know and what we need to do. Cancer. 2005;104(12 Suppl):2895–902.

    Article  PubMed  Google Scholar 

  29. Kagawa-Singer M, Pourat N, Breen N, et al. Breast and cervical cancer screening rates of subgroups of Asian American women in California. Med Care Res Rev. 2007;64:706–30.

    Article  PubMed  Google Scholar 

  30. Ryerson A, Benard V, Major A. National Breast and Cervical Cancer Early Detection Program: 1991–2002 national report. Atlanta, GA: Centers for Disease Control and Prevention. Available at http://www.cdc.gov/cancer/dcpc/library/online/bc.htm. Accessed April 11, 2009.

  31. Smith RA, Cokkinides V, Eyre HJ. Cancer screening in the United States, 2007: a review of current guidelines, practices, and prospects. CA Cancer J Clin. 2007;57:90–104.

    Article  CAS  PubMed  Google Scholar 

  32. National Breast and Cervical Cancer Early Detection Program. National aggregate. http://www.cdc.gov/cancer/nbccedp/data/summaries/national_aggregate.htm#cervical. Accessed April 11, 2009.

  33. Blake DR, Weber BM, Fletcher KE. Adolescent and young adult women’s misunderstanding of the term Pap smear. Arch Pediatr Adolesc Med. 2004;158:966–70.

    Article  PubMed  Google Scholar 

  34. Pizarro J, Schneider TR, Salovey P. A source of error in self-reports of Pap test utilization. J Community Health. 2002;27:351–6.

    Article  PubMed  Google Scholar 

  35. Fiscella K, Holt K, Meldrum S, et al. Disparities in preventive procedures: comparisons of self-report and Medicare claims data. BMC Health Serv Res. 2006;6:1–8.

    Article  Google Scholar 

  36. Sudman S, Warnecke R, Johnson T, et al. Cognitive aspects of reporting cancer prevention examinations and tests. Vital Health Stat. 1994;6(7):324–9.

    Google Scholar 

  37. Newell S, Girgis A, Sanson-Fisher R, et al. Accuracy of patients’ recall of Pap and cholesterol screening. Am J Public Health. 2000;90:1431–5.

    Article  CAS  PubMed  Google Scholar 

  38. Nguyen TT, McPhee SJ, Nguyen T, et al. Predictors of cervical Pap smear screening awareness, intention, and receipt among Vietnamese-American women. Am J Prev Med. 2002;23:207–14.

    Article  PubMed  Google Scholar 

  39. Ponce NA, Chawla N, Babey SH, et al. Is there a language divide in Pap test use? Med Care. 2006;44:998–1004.

    Article  PubMed  Google Scholar 

  40. Kagawa-Singer M, Pourat N. Asian American and Pacific Islander breast and cervical carcinoma screening rates and Healthy People 2000 objectives. Cancer. 2000;89:696–705.

    Article  CAS  PubMed  Google Scholar 

  41. Yu ESE, Kim KK, Chen EH, et al. Breast and cervical cancer screening among Chinese American women. Cancer Pract. 2001;9:81–91.

    Article  CAS  PubMed  Google Scholar 

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Acknowledgments

We acknowledge the helpful comments from the participants at the conference and anonymous reviewers. Any error remains ours. This study was funded by National Institute of Child Health and Human Development, USA (R01HD046697 to the University of Minnesota (PI: Lynn A. Blewett)).

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Authors and Affiliations

  1. Division of Health Policy and Management, School of Public Health, University of Minnesota, 2221 University Avenue SE, Suite 345, Minneapolis, MN, 55414, USA

    Tzy-Chyi Yu, Chiu-Fang Chou, Pamela Jo Johnson & Andrew Ward

  2. State Health Access Data Assistance Center, University of Minnesota, Minneapolis, MN, USA

    Tzy-Chyi Yu, Chiu-Fang Chou & Pamela Jo Johnson

  3. Minnesota Population Center, University of Minnesota, 50 Willey Hall, 225 19th Avenue S., Minneapolis, MN, 55455, USA

    Tzy-Chyi Yu, Chiu-Fang Chou, Pamela Jo Johnson & Andrew Ward

  4. HealthCore, Inc., 800 Delaware Avenue, Fifth Floor, Wilmington, DE, 19801-1366, USA

    Tzy-Chyi Yu

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  1. Tzy-Chyi Yu
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Correspondence to Tzy-Chyi Yu.

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Yu, TC., Chou, CF., Johnson, P.J. et al. Persistent Disparities in Pap Test Use: Assessments and Predictions for Asian Women in the U.S., 1982–2010. J Immigrant Minority Health 12, 445–453 (2010). https://doi.org/10.1007/s10903-009-9255-6

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  • DOI: https://doi.org/10.1007/s10903-009-9255-6

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