title: Cervical cancer screening in medically underserved California Latina and non-Latina women: effect of age and regularity of Pap testing.
abstract: BACKGROUND
  This study focuses on age, race/ethnicity and regular cervical cancer screening of medically underserved Latina and non-Latina women enrolled in California's Cancer Detection Programs: Every Woman Counts (CDP: EWC).
  
  
  METHODS
  Data from a cohort of women were evaluated for regularity of screening and ethnicity utilizing multi-category logistic regression models to investigate Pap test and biopsy results.
  
  
  RESULTS
  There was no statistically significant difference among medically underserved Latina or non-Latina women in Pap test result and stage of cervical cancer after controlling for age and screening regularity. Rarely/never Pap-tested women were more likely to have 'SIL/ASC' (odds ratio=1.19; 95% confidence interval=1.08, 1.31) compared to women who were screened regularly. Medically underserved 25-39-year-old women were also more likely to be identified with 'SIL/ASC' (odds ratio=1.64; 95% confidence interval=1.50, 1.79) than women 50 and over. Younger were more likely to have low-grade 'HPV/Condylomata, Atypia/CINI/LSIL' (odds ratio=2.48; 95% confidence interval=1.66, 3.72) and high-grade 'CIN II/III/HSIL/CI/Other Cancers' (odds ratio=1.53; 95% confidence interval=1.08, 2.16) than women age 40 and above, similar to rarely/never Pap-tested women.
  
  
  CONCLUSIONS
  Women were more likely to be identified with high-grade precancerous cervical lesions and cancer process when they did not have regular screening, Ethnic differences in screening outcomes seem to be minimized by participation in a program that provides consistent screening resources to the medically underserved women who enroll. These findings support prevention strategies that expand screening to all medically underserved younger women or that provide HPV vaccination at an early age.
authors.affiliation: Department of Pathology and Laboratory Medicine, University of California, Davis School of Medicine, 4400 V Street, Sacramento, CA 95817, USA. lydia.howell@ucdmc.ucdavis.edu
authors.forename: Lydia Pleotis
authors.initials: LP
authors.lastname: Howell
authors.forename: Sunitha
authors.initials: S
authors.lastname: Gurusinghe
authors.forename: Farzaneh
authors.initials: F
authors.lastname: Tabnak
authors.forename: Stan
authors.initials: S
authors.lastname: Sciortino
mesh_terms: D000328:Adult; D000367:Age Factors; D002140:California / Q000453:epidemiology; D015331:Cohort Studies; D016001:Confidence Intervals; D055088:Early Detection of Cancer; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D008403:Mass Screening; D008507:Medically Underserved Area; D008875:Middle Aged; D009367:Neoplasm Staging; D016017:Odds Ratio; D030361:Papillomavirus Infections / Q000145:classification / Q000175:diagnosis / Q000208:ethnology / Q000473:pathology; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis* / Q000208:ethnology / Q000473:pathology; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000208:ethnology / Q000473:pathology; D014626:Vaginal Smears / Q000706:statistics & numerical data*