The impact of age on adherence to cervical cancer screening guidelines Público

Abstract

Prior to 2012, cervical cancer screening guidelines changed many times, and differed in the initiation, frequency, and discontinuance of cervical cancer screening by recommending organizations. In 2012, cervical cancer screening guidelines from the American Cancer Society/American Society for Colposcopy and Cervical Pathology/American Society for Clinical Pathology (ACS/ASCCP/ASCP), the U.S. Preventive Services Task Force (USPSTF), and the American Congress of Obstetricians and Gynecologists (ACOG) became consistent, recommending women be screened every 3 years, starting at age 21 and stopping at age 65. Using logistic regression, we examined if women's age predicts the adherence to cervical cancer screening guidelines, controlling for demographics, health care use, and health status. Although all women were more likely to adhere to screening guidelines in 2012 than in 2010, we found that women ages 30-49 had 20.6 percentage points higher probability to adhere to guidelines, whereas elderly women had 35.7 percentage points lower probability adhere to guidelines compared to women ages 18-20. Compared to women in the same age group in 2010, adult women were more likely to adhere to cervical cancer screening recommendations in 2012; whereas elderly women had 16.5 percentage points lower probability to adhere to guidelines. Additionally, elderly women had 0.76 percentage point higher probability to overuse screening for 1 year increase in age. Furthermore, we found that among younger women (only women eligible for HPV vaccination), those who completed all 3 doses of HPV vaccines had 8.9 percentage points lower probability to adhere to guidelines compared to those who never vaccinated. These findings indicate that age is an important consideration in understanding whether women will adhere to the new, consistent guidelines

Table of Contents

Introduction.............................................................1
Literature Review......................................................2
Cervical cancer prevention..........................................2
Current cervical cancer screening recommendations.........2
Adherence to guidelines..............................................4
New contributions......................................................5
Methods .................................................................7
Research questions and hypotheses..............................7
Data sources and samples...........................................7
Conceptual framework...............................................10
Variables.................................................................11
Statistical Analyses...................................................15
Results...................................................................16
Descriptive characteristics.........................................16
Multivariate analysis..................................................20
Subgroup analyses....................................................25
HPV vaccination.......................................................25
Overuse of cervical cancer screening...........................30
Discussions.............................................................33
Clinical and Policy Implications....................................35
Limitations..............................................................35
Future Research......................................................36
Conclusion..............................................................38
Reference...............................................................39

About this Master's Thesis

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School	Rollins School of Public Health
Department	Health Policy and Management
Degree	MSPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Public Health
Palavra-chave	cervical cancer screening Humanpapiloma virus guidelines HPV compliance adherence recommendations
Committee Chair / Thesis Advisor	Gaydos, Laurie, Emory University
Committee Members	Joski, Peter J, Emory University Lipscomb, Joseph, Emory University
Partnering Agencies	CDC

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