Racial Disparities in Cervical Cancer Screening: Implications for Relieving Cervical Cancer Burden in Asian American Pacific Islander Women

BACKGROUND

While cervical cancer is considered preventable and the overall Papanicolaou (Pap) test utilization rate has gradually increased in the United States, certain Asian American Pacific Islander (AAPI) women consistently rate lower in Pap test receipt compared with non-Latina whites (NLWs), leading to a higher cervical cancer mortality rate for various AAPI women. Few studies, however, have focused on female AAPI college students' cervical cancer screening behavior in comparison with NLW students.

OBJECTIVE

This study aimed to investigate cervical cancer screening behaviors among college-aged females by (1) determining AAPIs' and NLWs' screening rates, (2) assessing their knowledge about Pap tests, and (3) discovering factors associated with Pap test receipt. Andersen's Health Behavioral Model was used as a theoretical framework.

METHODS

Using a simple random sampling strategy, 2270 female students (15% AAPIs, 85% NLWs) completed an online health survey.

RESULTS

Results indicate AAPI students had significantly lower Pap test knowledge and Pap test receipt rate compared with NLW students. Age, nativity, human papillomavirus vaccination completion, frequency of obstetrician/gynecologist (OB/GYN) visits, and the number of sexual partners were associated with AAPI students' lower rate of Pap test receipt, whereas the Pap test receipt rate for NLW students was influenced by the same factors with the addition of having increased prior knowledge about Pap tests.

CONCLUSION

Results show the importance of OB/GYN visits in obtaining Pap tests for AAPI and NLW students.

IMPLICATION FOR PRACTICE

Health practitioners should pay attention to students' race/ethnicity in their practice and provide corresponding ethnic group-specific preventive care.

Disparities in Human Papillomavirus Vaccine Literacy and Vaccine Completion Among Asian American Pacific Islander Undergraduates: Implications for Cancer Health Equity

PURPOSE

Low rates of human papillomavirus (HPV) vaccination among young Asian American and Pacific Islander (AAPI) women need to be addressed, particularly given the high incidence of cervical cancer in this population. The current study aims to investigate predictors of HPV vaccination in young AAPI and non-Latina white (NLW) women.

METHODS

A secondary data analysis was conducted of a health survey administered to college-aged women (N = 2,270) at a large public university in the Midwest. Andersen's behavioral model of health services utilization guided the study theoretically, and hierarchical logistic regression analysis was conducted to investigate research aim.

RESULTS

NLW women had a significantly higher rate of vaccine completion than AAPI women (NLW = 60.7%; AAPI = 38.6%). NLW women also scored higher on all 5 measures of HPV vaccine literacy than AAPI women. Both groups of undergraduate women reported that increasing age, knowledge about HPV, greater use of gynecological services, and knowing someone who had cancer were significant factors related to HPV vaccination completion. In the NLW group, father's income was also found to be a predictor of HPV vaccination completion.

CONCLUSIONS

Rate and predictors of HPV vaccination completion vary between NLW and AAPI women. Greater promotion of HPV literacy and gynecological service use should be made to young AAPI women to increase their HPV uptake. Further research should examine sociocultural factors that could hinder or promote HPV vaccination in young AAPI women.

Female college students’ beliefs about cervical cancer screening

Purpose

To explore female college students’ perceived benefits and barriers to cervical cancer screening and perceived vulnerability to cervical cancer.

Method

The study was exploratory and cross sectional. The Pap Smear Belief Questionnaire was distributed online to a sample of 267 female undergraduate baccalaureate nursing students.

Findings

Students who obtained routine Pap smears perceived greater benefits and fewer barriers to routine screening than the students who did not obtain routine Pap smears. Personal vulnerability to cervical cancer was not a significant finding. Students who were in a long-term relationship, non-smoking and initiated sexual intercourse at a younger age were more likely to obtain routine screening.

Conclusion

Stressing importance of preventive health care associated with routine cervical cancer screening is important to promote women’s health regardless of age or level of education. Further studies with a broader range of college students as participants are needed to better understand their beliefs about the benefits and barriers to obtaining routine screening, and their perceptions of vulnerability to cervical cancer.