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1 "Unnecessary procedures"
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Original Article
Determinants of Potentially Unnecessary Cervical Cancer Screenings in American Women
Munseok Seo, James R. Langabeer II
J Prev Med Public Health. 2018;51(4):181-187.   Published online June 7, 2018
DOI: https://doi.org/10.3961/jpmph.18.023
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AbstractAbstract PDF
Objectives
To identify factors responsible for potentially clinically unnecessary cervical cancer screenings in women with prior hysterectomy.
Methods
A retrospective cross-sectional study was conducted using the Centers for Disease Control and Prevention’s Behavioral Risk Factor Surveillance System (BRFSS). This study targeted adult women and examined whether they received a both a Papanicolaou (Pap) test and undergone a hysterectomy in the last three years. We conducted multivariate analyses, including weighted proportions and odds ratios (ORs), based on the modified BRFSS weighting method (raking). The inclusion criteria were adult women (>18 years old) who reported having received a Pap test within the last 3 years.
Results
Of all women (n=252 391), 72 366 had received a Pap test, and 32 935 of those women (45%, or 12.5 million, weighted) had a prior hysterectomy. We found that age, race/ethnicity, marital status, family income, health status, time since last routine checkup, and health insurance coverage were all significant predictors. Black, non-Hispanic women were 2.23 times more likely to receive Pap testing after a hysterectomy than white women (OR, 2.23; 95% confidence interval [CI], 1.99 to 2.50). Similarly, the odds for Hispanic women were 2.34 times higher (OR, 2.34; 95% CI, 1.97 to 2.80). The odds were also higher for those who were married (OR, 1.17; 95% CI, 1.08 to 1.27), healthier (OR, 1.24; 95% CI, 1.14 to 1.35), and had health insurance (OR, 1.54; 95% CI, 1.28 to 1.84), after controlling for confounders.
Conclusions
We conclude that women may potentially receive Pap tests even if they are not at risk for cervical cancer, and may not be adequately informed about the need for screenings. We recommend strategies to disseminate recommendations and information to patients, their families, and care providers.
Summary

Citations

Citations to this article as recorded by  
  • Three large scale surveys highlight the complexity of cervical cancer under-screening among women 45–65 years of age in the United States
    Diane M. Harper, Melissa Plegue, Kathryn M. Harmes, Masahito Jimbo, Sherri SheinfeldGorin
    Preventive Medicine.2020; 130: 105880.     CrossRef
  • Socio-demographic Characteristics and Use of Pap Smear for Cervical Cancer Screening Among Women of Eastern Part of India
    Dipanwita Ghosh, Sutapa Mahata, Pranab Kumar Sahoo, Sinjini Sarkar, Asoke Roy, Karabi Datta, Manisha Vernekar, Syamsundar Mandal, Vilas D. Nasare
    Indian Journal of Gynecologic Oncology.2019;[Epub]     CrossRef
  • 2019 Update on Medical Overuse
    Daniel J. Morgan, Sanket S. Dhruva, Eric R. Coon, Scott M. Wright, Deborah Korenstein
    JAMA Internal Medicine.2019; 179(11): 1568.     CrossRef

JPMPH : Journal of Preventive Medicine and Public Health
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