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
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