Role of patient race/ethnicity, insurance and age on Pap smear compliance across ten community health centers in Florida.

Abstract

Community Health Centers (CHCs) are the nation's primary care safety net for vulnerable populations, including racial/ethnic minorities, immigrants, migrant workers, and those who are uninsured. Women from such population sub-groups contribute disproportionately to cervical cancer incidence, morbidity, and mortality due, in large part, to the underutilization of Papanicolau (Pap) smear screening. Routine Pap smear screening can detect the onset and prevent progression of cervical malignancies. This article reports findings of a cross-sectional study to investigate the association between Pap smear compliance and patient race/ethnicity, insurance, and age for more than 60,000 women seen in a network of CHCs in Florida. Results of this study indicated a strong association between race/ ethnicity and Pap smear screening in CHCs. Among women aged 21-45 years, Hispanics were twice as likely to receive Pap smear screening, while Blacks were 1.45 times more likely to receive Pap smear screening, when compared to White women. These results were unexpected because most studies have shown that Hispanic women are less likely to receive screening than their Black and White counterparts. These findings highlight the need to further explore the contribution of race/ethnicity, insurance, age, and other risks on health disparities associated with cervical cancer screening in CHCs. Moreover, results from this study have subsequently led to the development of clinical data reporting software to support Pap smear compliance monitoring within CHCs, as well as best practices regarding standardized documentation of Pap smear within electronic health records.