Pratte Morgan A, Griffin Amy, Ogazi Chioma, Yurasevecz Susan, Blanks Carol A, McCooey Lisa, Kaufman Joy S
Department of Family Medicine, SUNY Upstate Medical University, Syracuse, New York.
Program and Service System Evaluation, The Consultation Center, New Haven, Connecticut.
Health Equity. 2018 Apr 1;2(1):30-36. doi: 10.1089/heq.2017.0038. eCollection 2018.
Racial/ethnic minority women are at increased risk for cervical cancer. The objective of this study is to use performance management data from the Connecticut Breast and Cervical Cancer Early Detection Program (CBCCEDP) to determine whether race/ethnicity disparities exist in human papillomavirus (HPV) co-testing uptake across CBCCEDP contractors. Secondary analysis of Connecticut's Minimum Data Elements data for 2013-2015 among 10 contractors participating in the CBCCEDP. Participants included women aged 30-64 years and eligible to receive routine cervical cancer screening services through the CBCCEDP (=5,262). HPV co-testing uptake was compared across contractors and race/ethnicity groups within each contractor using chi-square and Fisher's exact tests as appropriate. Overall, 62.9% of women received HPV co-testing services. Significant differences in co-testing rates were detected between racial/ethnic groups when data were examined across all contractors (<0.001). Black women were least likely to receive co-testing (49.1%), while Hispanic women were most likely to receive co-testing (68.2%). When data were examined at the individual contractor level, significant differences between racial/ethnic groups were observed in 50% of the contractors. This study identified racial/ethnic disparities in uptake of HPV co-testing both overall and within individual contractors involved in the CBCCEDP. These findings will be used to guide program improvement with the goal of increasing quality and consistency of care for all women seeking screening services.
种族/族裔少数群体女性患宫颈癌的风险更高。本研究的目的是利用康涅狄格州乳腺癌和宫颈癌早期检测项目（CBCCEDP）的绩效管理数据，以确定参与CBCCEDP的各承包商在人乳头瘤病毒（HPV）联合检测接受率方面是否存在种族/族裔差异。对参与CBCCEDP的10个承包商在2013 - 2015年期间的康涅狄格州最低数据元素数据进行二次分析。参与者包括年龄在30 - 64岁且有资格通过CBCCEDP接受常规宫颈癌筛查服务的女性（=5262人）。根据情况使用卡方检验和费舍尔精确检验，比较各承包商之间以及每个承包商内部不同种族/族裔群体的HPV联合检测接受率。总体而言，62.9%的女性接受了HPV联合检测服务。在检查所有承包商的数据时，发现种族/族裔群体之间的联合检测率存在显著差异（<0.001）。黑人女性接受联合检测的可能性最小（49.1%），而西班牙裔女性接受联合检测的可能性最大（68.2%）。在个体承包商层面检查数据时，50%的承包商中观察到种族/族裔群体之间存在显著差异。本研究确定了在CBCCEDP涉及的整体以及个体承包商内部，HPV联合检测接受率方面存在种族/族裔差异。这些发现将用于指导项目改进，目标是提高所有寻求筛查服务女性的护理质量和一致性。
