Measuring cervical cancer risk: development and validation of the CARE Risky Sexual Behavior Index

Abstract

Objectives: To develop and validate a risky sexual behavior index specific to cervical cancer research.

Methods: Sexual behavior data on 428 women from the Community Awareness Resources and Education (CARE) study were utilized. A weighting scheme for eight risky sexual behaviors was generated and validated in creating the CARE Risky Sexual Behavior Index. Cutpoints were then identified to classify women as having a low, medium, or high level of risky sexual behavior.

Results: Index scores ranged from 0 to 35, with women considered to have a low level of risky sexual behavior if their score was less than six (31.3% of sample), a medium level if their score was 6–10 (30.6%), or a high level if their score was 11 or greater (38.1%). A strong association was observed between the created categories and having a previous abnormal Pap smear test (p < 0.001).

Conclusions: The CARE Risky Sexual Behavior Index provides a tool for measuring risky sexual behavior level for cervical cancer research. Future studies are needed to validate this index in varied populations and test its use in the clinical setting.

Fig. 1

Percentage of women reporting a history of an abnormal Pap smear test within each category of the CARE Risky Sexual Behavior Index. Note: Bars indicate the standard errors of the proportions