Aboriginal women have a higher risk of cervical abnormalities at screening; South Australia, 1993–2016

Ming Li, David Roder, Lisa J. Whop, Abbey Diaz, Peter D. Baade, Julia Ml Brotherton, Karen Canfell, Joan Cunningham, Gail Garvey, Suzanne P. Moore, Dianne L. O'Connell, Patricia C. Valery, John R. Condon

    Research output: Contribution to journalArticleResearchpeer-review

    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.

    Original languageEnglish
    Pages (from-to)104-112
    Number of pages9
    JournalJournal of Medical Screening
    Volume26
    Issue number2
    Early online date12 Nov 2018
    DOIs
    Publication statusPublished - 1 Jun 2019

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    South Australia
    Odds Ratio
    Confidence Intervals
    Uterine Cervical Neoplasms
    Cell Biology
    Registries
    Mortality
    Hospital Records
    Vulnerable Populations

    Cite this

    Li, Ming ; Roder, David ; Whop, Lisa J. ; Diaz, Abbey ; Baade, Peter D. ; Brotherton, Julia Ml ; Canfell, Karen ; Cunningham, Joan ; Garvey, Gail ; Moore, Suzanne P. ; O'Connell, Dianne L. ; Valery, Patricia C. ; Condon, John R. / Aboriginal women have a higher risk of cervical abnormalities at screening; South Australia, 1993–2016. In: Journal of Medical Screening. 2019 ; Vol. 26, No. 2. pp. 104-112.
    @article{116e01f127b64555b32f7068a3d817ad,
    title = "Aboriginal women have a higher risk of cervical abnormalities at screening; South Australia, 1993–2016",
    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.",
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    author = "Ming Li and David Roder and Whop, {Lisa J.} and Abbey Diaz and Baade, {Peter D.} and Brotherton, {Julia Ml} and Karen Canfell and Joan Cunningham and Gail Garvey and Moore, {Suzanne P.} and O'Connell, {Dianne L.} and Valery, {Patricia C.} and Condon, {John R.}",
    year = "2019",
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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 Ml; Canfell, Karen; Cunningham, Joan; Garvey, Gail; Moore, Suzanne P.; O'Connell, Dianne L.; Valery, Patricia C.; Condon, John R.

    In: Journal of Medical Screening, Vol. 26, No. 2, 01.06.2019, p. 104-112.

    Research output: Contribution to journalArticleResearchpeer-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 Ml

    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 - 2019/6/1

    Y1 - 2019/6/1

    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

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    U2 - 10.1177/0969141318810719

    DO - 10.1177/0969141318810719

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    VL - 26

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    EP - 112

    JO - Journal of Medical Screening

    JF - Journal of Medical Screening

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