Date of Award

January 2011

Document Type

Thesis

Degree Name

Medical Doctor (MD)

Department

Medicine

First Advisor

Marcella Nunez-Smith

Second Advisor

Marcela del Carmen

Subject Area(s)

Obstetrics and gynecology

Abstract

BARRIERS TO CERVICAL CANCER SCREENING AMONG HISPANIC WOMEN AND METHODS TO IMPROVE SCREENING ADHERENCE

Amanda E. Velazquez, Luisa Watts, Naima Joseph, Marisa Gonzalez, Elizabeth Munro, Alona Muzikansky, Jose A. Rauh-Hain, Marcela G. del Carmen, Department of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, MA. (Sponsored by Marcella Nunez-Smith, Department of Internal Medicine, Yale University School of Medicine)

A decrease in both the incidence and mortality of cervical cancer has occurred across all ethnic groups with the introduction of the Papanicolaou smear; however, Hispanics have the highest incidence and second highest mortality rate when compared to other racial/ethnic minority groups. Past studies have looked at barriers leading to this discrepancy, but to our knowledge, large-scale surveys of Hispanic women, particularly in the Northeast, have never been performed. Therefore, we created a one hundred and twenty-one question survey looking at demographics, ways of learning new information, health care utilization, and knowledge of Papanicolaou smears in order to determine barriers to screening in this population. Three hundred and eighteen Hispanic women participated in our study. The results were stratified based on age, number of years living in the United States, and number of lifetime Papanicolaou smears. Older women and those living in the United States for less than five years preferred speaking Spanish at home and during health care encounters. Those women living in the United States for less than five years were less likely to have routine health care visits, mammograms, and Papanicolaou smears. Having five or more lifetime Papanicolaou smears increases the likelihood of regular mammogram screening. Our study found that age and number of years living in the United States may be independent risk factors for barriers contributing to disparities in cervical cancer screening.

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