Cervical cancer screening rates low in poor areas

Black women living in poor communities are less likely to be up-to-date with cervical cancer screening than those living in wealthier areas, according to new findings from the Black Women's Health Study.

"This suggests that in addition to individual-level intervention to increase cervical cancer screening, there might be some benefit in neighborhood-level interventions focusing on high-poverty areas," said Dr. Geetanjali Datta, from Harvard School of Public Health in Boston.

Cervical cancer is the fifth most common cancer among African American women in the US, Datta and her colleagues note in the medical journal Cancer. Also, a recent report by the National Cancer Institute observed that women living in high-poverty areas have a 71 percent higher cervical cancer mortality rate than women living in wealthier areas.

While screening for cervical cancer with a Pap test is recommended at least every three years, socioeconomic factors can make it difficult for some women to get tested.

"One of the US's Healthy People 2010 goal is to decrease the proportion of black women who are not up-to-date on their screening from 17 percent to 10 percent," said Datta.

Datta's team examined individual, neighborhood, and state level factors related to cervical cancer screening in a population of approximately 40,000 black women. The researchers found that, overall, 8.3 percent of these women had not undergone a Pap smear test within the previous 2 years.

As previously reported, lower education, older age, obesity and smoking are factors associated with lower adherence. After adjusting for these individual characteristics, the results suggest that living in neighborhoods where the poverty rate is 20 percent or higher is associated with lower rates of cervical cancer screenings.

"Is not clear what is causing these disparities and we were not able to assess those aspects in this particular study," said Datta. "We can only speculate that it might be due to a lack of resources such as transportation, daycare or health centers in deprived areas."

SOURCE: Cancer, February 1, 2006.