title: Adherence to US Preventive Services Task Force recommendations for breast and cervical cancer screening for women who have a spinal cord injury.
abstract: Women with spinal cord injury (SCI) may face barriers that result in disparities in receipt of recommended mammography and Papanicolaou testing.
  
  
  
  South Carolina.
  
  
  
  South Carolina women with SCI were identified using International Classification of Diseases codes in 2000-2010 Medicaid and Medicare billing data.
  
  
  
  Receipt of mammography and Pap testing was determined using procedure billing codes. Partial proportional odds models were estimated to examine the association between SCI and adherence with screening recommendations from the United States Preventive Services Task Force. Each individual's screening experience was classified as full adherence, partial adherence, or no screening.
  
  
  
  The cohort for mammography consisted of 3,173 women with SCI and 6,433 comparison women without SCI. The cohort for Pap testing consisted 5,025 women with SCI and 9,538 comparison women. Women with SCI were less likely to have full adherence with mammography recommendations (aOR = 0.69, 95% CI 0.64, 0.76) and Pap test recommendations (aOR = 0.53, 95% CI 0.49, 0.57). They were more likely to have no mammography screening (aOR = 1.44, 95% CI 1.33, 1.57) and no Pap testing (aOR = 1.89, 95% CI 1.77, 2.03) than women without SCI.
  
  
  
  Using longitudinal data with multiple outcome levels, women with SCI were less likely to be fully adherent with receipt of recommended breast and cervical cancer screenings and more likely to have no screenings during the eligible years when compared to women without SCI.
authors.affiliation: a Department of Epidemiology and Biostatistics , University of South Carolina Arnold School of Public Health , Columbia , SC , USA.
authors.forename: Xinling
authors.initials: X
authors.lastname: Xu
authors.affiliation: b Department of Preventive Medicine . University of Mississippi Medical Center , Jackson , MS , USA.
authors.forename: Joshua R
authors.initials: JR
authors.lastname: Mann
authors.affiliation: a Department of Epidemiology and Biostatistics , University of South Carolina Arnold School of Public Health , Columbia , SC , USA.
authors.forename: James W
authors.initials: JW
authors.lastname: Hardin
authors.affiliation: c Department of Family and Preventive Medicine , University of South Carolina School of Medicine , Columbia , SC , USA.
authors.forename: Erin
authors.initials: E
authors.lastname: Gustafson
authors.affiliation: a Department of Epidemiology and Biostatistics , University of South Carolina Arnold School of Public Health , Columbia , SC , USA.
authors.forename: Suzanne W
authors.initials: SW
authors.lastname: McDermott
authors.affiliation: d Biostatistics and Research Design Unit , University of Missouri Columbia School of Medicine , Columbia , MO , USA.
authors.forename: Chelsea B
authors.initials: CB
authors.lastname: Deroche
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000453:epidemiology; D005260:Female; D019983:Guideline Adherence; D054625:Healthcare Disparities / Q000706:statistics & numerical data*; D006801:Humans; D008327:Mammography / Q000706:statistics & numerical data; D008875:Middle Aged; D065006:Papanicolaou Test / Q000706:statistics & numerical data; D011315:Preventive Medicine / Q000592:standards* / Q000706:statistics & numerical data; D013022:South Carolina; D013119:Spinal Cord Injuries / Q000150:complications* / Q000453:epidemiology; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000453:epidemiology
keywords: Spinal cord injuries, Mammography, Papanicolaou test, Healthcare disparities, Cancer screening