Timeliness and follow-up patterns of cervical cancer detection in a cohort of medically underserved California women.
BACKGROUND
This study examines factors associated with timely follow-up after Pap test in a program providing cervical cancer detection services to medically underserved California women.


METHODS
Data between 01 January 1992 and 30 June 2007 were analyzed. Cox proportional hazard regression was used to identify subgroups of women with delayed time to diagnosis or treatment scheduling. The probability of being scheduled for final diagnosis and treatment was assessed using logistic regression analysis. Demographic and clinical characteristics of the women lost to follow up were examined.


RESULTS
Time from screening to final diagnosis scheduling differed according to age group, race/ethnicity, and Pap test result. Race/ethnicity and age were associated with whether treatment was scheduled or not. While loss to follow up among those scheduled for final diagnosis was associated with certain patients' characteristics, no such association was found among those who were scheduled for treatment.


CONCLUSIONS
Patient's demographic characteristics determine the odds of being scheduled for final diagnosis and treatment as well as timeliness of follow-up from screening to final diagnosis. Findings suggest that the dual goal of reducing health disparities and cost-effective detection and treatment of precancerous disease to prevent cervical cancers cannot be achieved without consideration of racial/ethnic differences and needs.
Tabnak
Farzaneh
F
California Department of Public Health, Sacramento, USA. farzaneh.tabnak@cdph.ca.gov
Müller
Hans-Georg
HG
Wang
Jane-Ling
JL
Zhang
Weihong
W
Howell
Lydia Pleotis
LP
D000328:Adult; D000368:Aged; D001294:Attitude to Health; D002140:California / Q000453:epidemiology; D055088:Early Detection of Cancer / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D054624:Health Status Disparities; D054625:Healthcare Disparities; D006801:Humans; D008403:Mass Screening / Q000706:statistics & numerical data; D008507:Medically Underserved Area; D008875:Middle Aged; D009367:Neoplasm Staging; D012189:Retrospective Studies; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis* / Q000453:epidemiology; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000453:epidemiology; D014626:Vaginal Smears / Q000706:statistics & numerical data*; D014932:Women's Health Services / Q000458:organization & administration; D055815:Young Adult