Cervical abnormalities are more common among Indigenous than other Australian women

A retrospective record-linkage study, 2000-2011

Lisa Whop, Peter Baade, Gail Garvey, Joan Cunningham, Julia Brotherton, Kamalini Lokuge, Patricia Valery, Dianne L. O'Connell, Karen Canfell, Abbey Diaz, David Roder, DM Gertig, Suzanne Moore, John Condon

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    Abstract

    Indigenous Australian women have much higher incidence of cervical cancer compared to non-Indigenous women. Despite an organised cervical screening program introduced 25 years ago, a paucity of Indigenous-identified data in Pap Smear Registers remains. Prevalence of cervical abnormalities detected among the screened Indigenous population has not previously been reported. We conducted a retrospective cohort study of populationbased linked health records for 1,334,795 female Queensland residents aged 20-69 years who had one or more Pap smears during 2000-2011; from linked hospital records 23,483 were identified as Indigenous. Prevalence was calculated separately for Indigenous and non-Indigenous women, for cytology-detected low-grade (cLGA) and highgrade abnormalities (cHGA), and histologically confirmed high-grade abnormalities (hHGA). Odds ratios (OR) were estimated from logistic regression analysis. In 2010-2011 the prevalence of hHGA among Indigenous women (16.6 per 1000 women screened, 95% confidence interval [CI] 14.6-18.9) was twice that of non-Indigenous women (7.5 per 1000 women screened, CI 7.3-7.7). Adjusted for age, area-level disadvantage and place of residence, Indigenous women had higher prevalence of cLGA (OR 1.4, CI 1.3-1.4), cHGA (OR 2.2, CI 2.1-2.3) and hHGA (OR 2.0, CI 1.9-2.1). Our findings show that Indigenous women recorded on the Pap Smear Register have much higher prevalence for cLGA, cHGA and hHGA compared to non-Indigenous women. The renewed cervical screening program, to be implemented in 2017, offers opportunities to reduce the burden of abnormalities and invasive cancer among Indigenous women and address long-standing data deficiencies.
    Original languageEnglish
    Article numbere0150473
    Pages (from-to)1-12
    Number of pages12
    JournalPLoS One
    Volume11
    Issue number4
    DOIs
    Publication statusPublished - 2016

    Fingerprint

    Cytology
    linkage (genetics)
    Screening
    confidence interval
    Papanicolaou Test
    odds ratio
    Regression analysis
    Confidence Intervals
    Logistics
    Odds Ratio
    cell biology
    Health
    Cell Biology
    screening
    Queensland
    uterine cervical neoplasms
    Hospital Records
    cohort studies
    Population Groups
    Uterine Cervical Neoplasms

    Cite this

    Whop, Lisa ; Baade, Peter ; Garvey, Gail ; Cunningham, Joan ; Brotherton, Julia ; Lokuge, Kamalini ; Valery, Patricia ; O'Connell, Dianne L. ; Canfell, Karen ; Diaz, Abbey ; Roder, David ; Gertig, DM ; Moore, Suzanne ; Condon, John. / Cervical abnormalities are more common among Indigenous than other Australian women : A retrospective record-linkage study, 2000-2011. In: PLoS One. 2016 ; Vol. 11, No. 4. pp. 1-12.
    @article{5542dbf2317b40a58dd293650a96acdb,
    title = "Cervical abnormalities are more common among Indigenous than other Australian women: A retrospective record-linkage study, 2000-2011",
    abstract = "Indigenous Australian women have much higher incidence of cervical cancer compared to non-Indigenous women. Despite an organised cervical screening program introduced 25 years ago, a paucity of Indigenous-identified data in Pap Smear Registers remains. Prevalence of cervical abnormalities detected among the screened Indigenous population has not previously been reported. We conducted a retrospective cohort study of populationbased linked health records for 1,334,795 female Queensland residents aged 20-69 years who had one or more Pap smears during 2000-2011; from linked hospital records 23,483 were identified as Indigenous. Prevalence was calculated separately for Indigenous and non-Indigenous women, for cytology-detected low-grade (cLGA) and highgrade abnormalities (cHGA), and histologically confirmed high-grade abnormalities (hHGA). Odds ratios (OR) were estimated from logistic regression analysis. In 2010-2011 the prevalence of hHGA among Indigenous women (16.6 per 1000 women screened, 95{\%} confidence interval [CI] 14.6-18.9) was twice that of non-Indigenous women (7.5 per 1000 women screened, CI 7.3-7.7). Adjusted for age, area-level disadvantage and place of residence, Indigenous women had higher prevalence of cLGA (OR 1.4, CI 1.3-1.4), cHGA (OR 2.2, CI 2.1-2.3) and hHGA (OR 2.0, CI 1.9-2.1). Our findings show that Indigenous women recorded on the Pap Smear Register have much higher prevalence for cLGA, cHGA and hHGA compared to non-Indigenous women. The renewed cervical screening program, to be implemented in 2017, offers opportunities to reduce the burden of abnormalities and invasive cancer among Indigenous women and address long-standing data deficiencies.",
    author = "Lisa Whop and Peter Baade and Gail Garvey and Joan Cunningham and Julia Brotherton and Kamalini Lokuge and Patricia Valery and O'Connell, {Dianne L.} and Karen Canfell and Abbey Diaz and David Roder and DM Gertig and Suzanne Moore and John Condon",
    note = "NHMRC Project Grant [#104559] , (NHMRC) Research Fellowship [#1058244] , NHMRC Career Development Fellowship [#1083090] , NHMRC Project Grant [#104559] , (NHMRC) Training Scholarship for Indigenous Australian Health Research (No. 1055587)",
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    doi = "10.1371/journal.pone.0150473",
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    Cervical abnormalities are more common among Indigenous than other Australian women : A retrospective record-linkage study, 2000-2011. / Whop, Lisa; Baade, Peter; Garvey, Gail; Cunningham, Joan; Brotherton, Julia; Lokuge, Kamalini; Valery, Patricia ; O'Connell, Dianne L.; Canfell, Karen; Diaz, Abbey; Roder, David; Gertig, DM; Moore, Suzanne; Condon, John.

    In: PLoS One, Vol. 11, No. 4, e0150473, 2016, p. 1-12.

    Research output: Contribution to journalArticleResearchpeer-review

    TY - JOUR

    T1 - Cervical abnormalities are more common among Indigenous than other Australian women

    T2 - A retrospective record-linkage study, 2000-2011

    AU - Whop, Lisa

    AU - Baade, Peter

    AU - Garvey, Gail

    AU - Cunningham, Joan

    AU - Brotherton, Julia

    AU - Lokuge, Kamalini

    AU - Valery, Patricia

    AU - O'Connell, Dianne L.

    AU - Canfell, Karen

    AU - Diaz, Abbey

    AU - Roder, David

    AU - Gertig, DM

    AU - Moore, Suzanne

    AU - Condon, John

    N1 - NHMRC Project Grant [#104559] , (NHMRC) Research Fellowship [#1058244] , NHMRC Career Development Fellowship [#1083090] , NHMRC Project Grant [#104559] , (NHMRC) Training Scholarship for Indigenous Australian Health Research (No. 1055587)

    PY - 2016

    Y1 - 2016

    N2 - Indigenous Australian women have much higher incidence of cervical cancer compared to non-Indigenous women. Despite an organised cervical screening program introduced 25 years ago, a paucity of Indigenous-identified data in Pap Smear Registers remains. Prevalence of cervical abnormalities detected among the screened Indigenous population has not previously been reported. We conducted a retrospective cohort study of populationbased linked health records for 1,334,795 female Queensland residents aged 20-69 years who had one or more Pap smears during 2000-2011; from linked hospital records 23,483 were identified as Indigenous. Prevalence was calculated separately for Indigenous and non-Indigenous women, for cytology-detected low-grade (cLGA) and highgrade abnormalities (cHGA), and histologically confirmed high-grade abnormalities (hHGA). Odds ratios (OR) were estimated from logistic regression analysis. In 2010-2011 the prevalence of hHGA among Indigenous women (16.6 per 1000 women screened, 95% confidence interval [CI] 14.6-18.9) was twice that of non-Indigenous women (7.5 per 1000 women screened, CI 7.3-7.7). Adjusted for age, area-level disadvantage and place of residence, Indigenous women had higher prevalence of cLGA (OR 1.4, CI 1.3-1.4), cHGA (OR 2.2, CI 2.1-2.3) and hHGA (OR 2.0, CI 1.9-2.1). Our findings show that Indigenous women recorded on the Pap Smear Register have much higher prevalence for cLGA, cHGA and hHGA compared to non-Indigenous women. The renewed cervical screening program, to be implemented in 2017, offers opportunities to reduce the burden of abnormalities and invasive cancer among Indigenous women and address long-standing data deficiencies.

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