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. 2025 Apr 26;25(1):204.
doi: 10.1186/s12905-025-03741-z.

A cross-sectional analysis of factors associated with cervical cancer screening in a large midwest primary care setting

Jissy Cyriac  1 , Gregory D Jenkins  2 , Brittany A Strelow  3 , Danielle J O' Laughlin  3 , Joy N Stevens  3 , Kathy L MacLaughlin  4 , Jane W Njeru  3
Affiliations

A cross-sectional analysis of factors associated with cervical cancer screening in a large midwest primary care setting

Jissy Cyriac et al. BMC Womens Health. .

Abstract

Background: Lower cervical cancer screening (CCS) rates have been reported among non-White populations, older women, rural populations, and populations with low socioeconomic status (SES). We evaluate associations between CCS status and individual, healthcare, and SES variables in a large primary care setting in southeast Minnesota.

Methods: We identified participants assigned female sex at birth, aged 21-65 years, without hysterectomy, and eligible for CCS via cross-sectional analysis of the electronic health record. Subjects were categorized as having up-to-date CCS or not. Logistic regression was used to model CCS status, with odds ratios (OR) and respective confidence intervals (95% CI) calculated for single predictor models for demographic factors, co-morbidities, and healthcare utilization.

Results: Approximately 78% (30,670 subjects) were current with CCS (total N = 39,433). Individuals who were Hispanic [OR (95% CI): 0.69 (0.62, 0.76)], non-White [0.53 (0.5, 0.56)], foreign-born [0.49 (0.46, 0.52)], and/or had limited English proficiency [0.44 (0.40, 0.49)] had lower odds of up-to-date CCS compared to Non-Hispanic, White, US-born, and/or English-speaking individuals. Older age, higher comorbidity burden, greater healthcare utilization, and having a female primary care provider were associated with higher odds of up-to-date CCS, while an inactive online patient portal account had lower odds of up-to-date CCS. Individuals with lower SES had lower odds of up-to-date CCS compared to those with higher SES.

Conclusions: In our sample, disparities in CCS status were associated with specific individual, healthcare, and SES factors/characteristics. Our results identify populations that may benefit from targeted interventions to address CCS uptake.

Keywords: Cervical cancer prevention; Cervical cancer screening barriers; Immigrant women; Limited English Proficiency; Population with health disparities; Women’s health.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: This study was reviewed and approved by the Mayo Clinic Institutional Review Board, and participant consent was waived for this study (reference ID: 23–004802). Electronic health record data analysis performed in this study was done in accordance with the Minnesota Research Authorization process as outlined by the State of Minnesota Legislature: https://www.revisor.mn.gov/statutes/cite/144.295 . Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Individual level variables and odds of up-to-date CCS, cross-sectional analysis, October 3, 2023
Fig. 2
Fig. 2
Healthcare level variables and odds of up-to-date CCS, cross-sectional analysis, October 3, 2023
Fig. 3
Fig. 3
Surrogate markers of socioeconomic status and odds of up-to-date CCS, cross-sectional analysis, October 3, 2023
See this image and copyright information in PMC

References

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