• Geetanjali D Datta, Magnoudewa Priscille Pana, Marie-Hélène Mayrand, and Beth Glenn.
• Research Center of the Centre hospitalier de l'Université de Montréal (CRCHUM), Montréal, QC H2X 3E4, Canada; Department of Social and Preventive Medicine, Université de Montréal, Montreal, Quebec H3T 1J4, Canada; Department of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, United States of America. Electronic address: geetanjali.datta@cshs.org.
• Prev Med. 2022 Jun 1; 159: 107055.

AbstractIn the United states (U.S.), prevailing understanding suggests significant racial/ethnic inequalities in cervical cancer screening exist. However, recent findings elsewhere in North America indicate the magnitude of these inequalities depend on the way screening is defined: lifetime screening versus up-to-date screening. As those who have never been screened are most at risk for invasive cancer, an improved understanding of inequalities in this outcome is necessary to better inform interventions. To describe racial/ethnic inequalities in 1) never screening and 2) not being up-to-date with screening among women who have been screened at least once in their lifetime, three years (2014-2016) of the U.S. Behavioral Risk Factor Surveillance Survey were utilized to estimate cervical cancer screening prevalence ratios via Poisson regression (N = 123,070). The sample was limited to women age 21 to 65 years. Women from racial/ethnic minority groups were more likely to never have been screened in comparison to White women, particularly women of Asian descent (Prevalence Ratio (PR) = 3.8, 95% CI = 3.3-4.3). However, among women who had been screened at least once in their lifetime, an inverse association was observed between being a member of a racial/ethnic minority group and not being up-to-date with screening (e.g. PRasian vs white = 0.7, 95% CI = 0.6-0.9). Physicians and public health institutions concerned with monitoring racial/ethnic inequalities should consider adding lifetime screening as a primary benchmark, as this outcome implies different intervention targets to address inequalities and the differential burden of cervical cancer.Copyright © 2022. Published by Elsevier Inc.

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