Pap test use and cervical cancer incidence in First Nations women living in Manitoba.
This study examined Papanicolaou (Pap) test utilization, Pap test results, and cervical cancer incidence among First Nations (FN) women living in Manitoba, Canada taking into account age group, time period, and area of residence. Six population-based data sources were linked at an individual level. Negative binomial regression was used to compare Pap test utilization and results between FN and all other Manitoba (AOM) women. Poisson regression was used to compare cervical cancer incidence. Among women younger than 25 years, FN were more likely than AOM women to have had a Pap test [rate ratio (RR) = 1.37, 95% confidence intervals (CI), 1.22-1.53, 18-19 year olds; RR = 1.17, 95% CI, 1.05-1.31, 20-24 year olds]. There was no difference in Pap test use for women 25 to 29 or 30 to 39 years. FN 40 years and older were less likely to have a Pap test than AOM women (RR = 0.84, 95% CI, 0.75-0.93, 40-49 years old; RR = 0.71, 95% CI, 0.63-0.79, 50-59 years old; RR = 0.59, 95% CI, 0.52-0.66, 60-69 years old). FN were more likely than AOM women to have a high (RR = 1.88, 95% CI, 1.65-2.13) or low-grade Pap test result (RR = 1.60, 95% CI, 1.48-1.73). The invasive cervical cancer incidence rate was double for FN women 25 to 39 years of age (21.9 per 100,000, FN; 10.2 per 100,000, AOM, P = 0.006) and 40 to 69 years of age (24.3 per 100,000, FN; 12.3 per 100,000, AOM, P = 0.007). In conclusion, cervical cancer screening among FN women over 40 years of age must be increased to address the higher cervical cancer incidence.
Screening Programs, CancerCare Manitoba, Winnipeg, Manitoba, Canada. Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
Kathleen M
KM
Decker
Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada. Epidemiology and Cancer Registry, CancerCare Manitoba, Winnipeg, Manitoba, Canada.
Alain A
AA
Demers
Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada. Epidemiology and Cancer Registry, CancerCare Manitoba, Winnipeg, Manitoba, Canada. Cancer Control Research, British Columbia Cancer Agency, Vancouver, British Columbia, Canada.
Erich V
EV
Kliewer
Screening Programs, CancerCare Manitoba, Winnipeg, Manitoba, Canada.
Natalie
N
Biswanger
Epidemiology and Cancer Registry, CancerCare Manitoba, Winnipeg, Manitoba, Canada.
Grace
G
Musto
Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
Brenda
B
Elias
Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada. Epidemiology and Cancer Registry, CancerCare Manitoba, Winnipeg, Manitoba, Canada.
Jane
J
Griffith
Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada. Epidemiology and Cancer Registry, CancerCare Manitoba, Winnipeg, Manitoba, Canada. donna.turner@cancercare.mb.ca.
Donna
D
Turner
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D055088:Early Detection of Cancer / Q000379:methods*; D005260:Female; D005843:Geography; D006801:Humans; D015994:Incidence; D007198:Indians, North American; D008350:Manitoba; D008875:Middle Aged; D065006:Papanicolaou Test / Q000706:statistics & numerical data*; D016012:Poisson Distribution; D012042:Registries; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000453:epidemiology*; D055815:Young Adult