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.
AB - 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.
UR - http://www.scopus.com/inward/record.url?scp=84963735554&partnerID=8YFLogxK
U2 - 10.1371/journal.pone.0150473
DO - 10.1371/journal.pone.0150473
M3 - Article
C2 - 27064273
SN - 1932-6203
VL - 11
SP - 1
EP - 12
JO - PLoS One
JF - PLoS One
IS - 4
M1 - e0150473
ER -