Adherence to recommendations for follow-up to abnormal Pap tests.
OBJECTIVE
To evaluate whether timely adherence rates differ by race among women with abnormal Pap tests participating in a cost-free or reduced-cost program.


METHODS
Eligible subjects included women aged 47-64 years who received a referral for follow-up care after an abnormal Pap test from 1999 to 2002 in South Carolina (n=330). Adherence was measured as days to receipt of follow-up care after an abnormal Pap test. Cox proportional hazards modeling was used to estimate risk factors associated with time to adherence within 60 and 365 days by race.


RESULTS
African-American and non-Hispanic white women had similar adherence to follow-up. Among white women, those with high-grade lesions were less likely to adhere in a timely manner relative to those with low-grade lesions (hazard ratio 0.6, 95% confidence interval [CI] 0.4-1.0). For African-American women, rural residence (hazard ratio: 0.5, 95% CI 0.2-0.9) and history of abnormal Pap tests (hazard ratio 0.6, 95% CI 0.3-1.0) were associated with decreased adherence, whereas less education (hazard ratio 2.3, 95% CI 1.3-3.9) was associated with increased adherence.


CONCLUSIONS
Adherence rates do not differ by race. However, risk factors for adherence within race are variable. Interventions tailored to the differential needs of racial and ethnic groups may prove effective toward increasing timely adherence rates.


METHODS
II.
Eggleston
Katherine S
KS
University of Texas Health Science Center, School of Public Health, Houston, Texas 77025, USA. katherine.s.eggleston@uth.tmc.edu
Coker
Ann L
AL
Luchok
Kathryn J
KJ
Meyer
Tamra E
TE
D001741:Black or African American / Q000523:psychology* / Q000706:statistics & numerical data; D002584:Cervix Uteri / Q000473:pathology*; D003127:Colposcopy; D004522:Educational Status; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D010349:Patient Compliance / Q000208:ethnology; D016016:Proportional Hazards Models; D012959:Socioeconomic Factors; D013022:South Carolina; D013997:Time Factors; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000517:prevention & control; D014626:Vaginal Smears / Q000191:economics / Q000379:methods; D044465:White People / Q000523:psychology* / Q000706:statistics & numerical data