Abstract
Objective: Cervical cancer mortality has halved in Australia since the national cervical screening program began in 1991, but elevated mortality rates persist for Aboriginal and Torres Strait Islander women (referred to as Aboriginal women in this report). We investigated differences by Aboriginal status in abnormality rates predicted by cervical cytology and confirmed by histological diagnoses among screened women.
Methods: Using record linkage between cervical screening registry and
public hospital records in South Australia, we obtained Aboriginal status of
women aged 20–69 for 1993–2016 (this was not recorded by the registry).
Differences in cytological abnormalities were investigated by Aboriginal
status, using relative risk ratios from mixed effect multinomial logistic
regression modelling. Odds ratios were calculated for histological high grade
results for Aboriginal compared with non-Aboriginal women.
Results: Of 1,676,141 linkable cytology tests, 5.8% were abnormal.
Abnormal results were more common for women who were younger, never married,
and living in a major city or socioeconomically disadvantaged area. After
adjusting for these factors and numbers of screening episodes, the relative
risk of a low grade cytological abnormality compared with a normal test was 14%
(95% confidence interval 5–24%) higher, and the relative risk of a high grade
cytological abnormality was 61% (95% confidence interval 44–79%) higher, for
Aboriginal women. The adjusted odds ratio of a histological high grade was 76%
(95% confidence interval 46–113%) higher.
Conclusions: Ensuring that screen-detected abnormalities are followed up
in a timely way by culturally acceptable services is important for reducing
differences in cervical cancer rates between Aboriginal and non-Aboriginal
women.
| Language | English |
|---|---|
| Pages | 1-9 |
| Number of pages | 9 |
| Journal | Journal of Medical Screening |
| Early online date | 12 Nov 2018 |
| DOIs | |
| State | E-pub ahead of print - 12 Nov 2018 |
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Aboriginal women have a higher risk of cervical abnormalities at screening; South Australia, 1993–2016. / Li, Ming; Roder, David; Whop, Lisa J.; Diaz, Abbey; Baade, Peter D.; Brotherton, Julia M.L.; Canfell, Karen; Cunningham, Joan; Garvey, Gail; Moore, Suzanne P.; O’Connell, Dianne L.; Valery, Patricia C.; Condon, John R.
In: Journal of Medical Screening, 12.11.2018, p. 1-9.Research output: Contribution to journal › Article › Research › peer-review
TY - JOUR
T1 - Aboriginal women have a higher risk of cervical abnormalities at screening; South Australia, 1993–2016
AU - Li,Ming
AU - Roder,David
AU - Whop,Lisa J.
AU - Diaz,Abbey
AU - Baade,Peter D.
AU - Brotherton,Julia M.L.
AU - Canfell,Karen
AU - Cunningham,Joan
AU - Garvey,Gail
AU - Moore,Suzanne P.
AU - O’Connell,Dianne L.
AU - Valery,Patricia C.
AU - Condon,John R.
PY - 2018/11/12
Y1 - 2018/11/12
N2 - Objective: Cervical cancer mortality has halved in Australia since the national cervical screening program began in 1991, but elevated mortality rates persist for Aboriginal and Torres Strait Islander women (referred to as Aboriginal women in this report). We investigated differences by Aboriginal status in abnormality rates predicted by cervical cytology and confirmed by histological diagnoses among screened women. Methods: Using record linkage between cervical screening registry and public hospital records in South Australia, we obtained Aboriginal status of women aged 20–69 for 1993–2016 (this was not recorded by the registry). Differences in cytological abnormalities were investigated by Aboriginal status, using relative risk ratios from mixed effect multinomial logistic regression modelling. Odds ratios were calculated for histological high grade results for Aboriginal compared with non-Aboriginal women. Results: Of 1,676,141 linkable cytology tests, 5.8% were abnormal. Abnormal results were more common for women who were younger, never married, and living in a major city or socioeconomically disadvantaged area. After adjusting for these factors and numbers of screening episodes, the relative risk of a low grade cytological abnormality compared with a normal test was 14% (95% confidence interval 5–24%) higher, and the relative risk of a high grade cytological abnormality was 61% (95% confidence interval 44–79%) higher, for Aboriginal women. The adjusted odds ratio of a histological high grade was 76% (95% confidence interval 46–113%) higher. Conclusions: Ensuring that screen-detected abnormalities are followed up in a timely way by culturally acceptable services is important for reducing differences in cervical cancer rates between Aboriginal and non-Aboriginal women.
AB - Objective: Cervical cancer mortality has halved in Australia since the national cervical screening program began in 1991, but elevated mortality rates persist for Aboriginal and Torres Strait Islander women (referred to as Aboriginal women in this report). We investigated differences by Aboriginal status in abnormality rates predicted by cervical cytology and confirmed by histological diagnoses among screened women. Methods: Using record linkage between cervical screening registry and public hospital records in South Australia, we obtained Aboriginal status of women aged 20–69 for 1993–2016 (this was not recorded by the registry). Differences in cytological abnormalities were investigated by Aboriginal status, using relative risk ratios from mixed effect multinomial logistic regression modelling. Odds ratios were calculated for histological high grade results for Aboriginal compared with non-Aboriginal women. Results: Of 1,676,141 linkable cytology tests, 5.8% were abnormal. Abnormal results were more common for women who were younger, never married, and living in a major city or socioeconomically disadvantaged area. After adjusting for these factors and numbers of screening episodes, the relative risk of a low grade cytological abnormality compared with a normal test was 14% (95% confidence interval 5–24%) higher, and the relative risk of a high grade cytological abnormality was 61% (95% confidence interval 44–79%) higher, for Aboriginal women. The adjusted odds ratio of a histological high grade was 76% (95% confidence interval 46–113%) higher. Conclusions: Ensuring that screen-detected abnormalities are followed up in a timely way by culturally acceptable services is important for reducing differences in cervical cancer rates between Aboriginal and non-Aboriginal women.
KW - Aboriginal
KW - Cervical screening
KW - South Australia
UR - http://www.scopus.com/inward/record.url?scp=85058940457&partnerID=8YFLogxK
U2 - 10.1177/0969141318810719
DO - 10.1177/0969141318810719
M3 - Article
SP - 1
EP - 9
JO - Journal of Medical Screening
T2 - Journal of Medical Screening
JF - Journal of Medical Screening
SN - 0969-1413
ER -