Presentation Type
Poster
Discipline Track
Community/Public Health
Abstract Type
Research/Clinical
Abstract
Background: The Mays Cancer Center (MCC) is one of only four National Cancer Institute (NCI)-designated cancer centers in Texas and the only one in South Texas. The MCC serves 38 counties and over 4.9 million residents; 70% of residents are Hispanic, 25 of 38 counties are designated as rural areas; additionally, 25 of the 38 counties have census tracts designated as areas of persistent poverty. Catchment area residents are at disproportionately greater risk of developing liver and intrahepatic bile duct cancer (64%), cervical cancer (46%), gallbladder cancer (8%), gastric cancer (4%), and pediatric leukemia (32%) compared to the nation. Currently the Papanicolaou test (often called a pap test) is considered the most effective screening test for identifying abnormal cells associated with cervical cancer. During a pap-test, cervical cells are collected and examined for pre-cancerous or cancerous changes. When cancer is detected at an earlier stage, before symptoms start to appear, it is often easier to treat. For South Texas women, evidence suggests that barriers to receiving a pap-test include low health literacy, cultural beliefs and norms, and lack of health insurance coverage. Additionally, there is growing evidence that structural and social determinants of health (SDoH) also impact adherence to cancer screenings. The purpose of this study was to examine select SDoH that may be influencing South Texas women’s decisions to receive a pap test.
Methods: In the summer and fall of 2020, the MCC Community Outreach and Engagement team fielded the South Texas Survey. This survey captured information in seven specific domains, two of which are social determinants of health and cancer screening practices. This survey was designed using a probabilistic sampling frame for our catchment area with representation from a metropolitan and race and ethnicity perspective. A total of 555 individuals completed the survey of which 382 identified as female (69%). For this study, descriptive statistics and chi-square analysis were used to examine the study population. Generalized logistic regression were used to identify individual, social, and structural factors associated with cervical cancer screening uptake. All data were weighted, and analyses were conducted using the R statistical software.
Results: Overall, 80% of women indicated they had received a pap-test. When examining women who indicated not receiving a pap-test, a greater proportion were Hispanic, single and did not have health care coverage. For a SDoH perspective, regression results determined that at the individual level, single women had 89% lower odds of having received a pap-test compared to married women (OR: 0.11; CI: 0.03-0.42) and women who had a higher discrimination index score had 27% lower odds of having received a pap-test compared to women who had lower index scores (OR: 0.73; CI: 0.53-1.00). Conclusion: South Texas women who are single, report perceptions of greater discrimination, and/or do not have healthcare coverage are less likely to have a pap test. Results provide insight into the influence of social and structural determinants of health on South Texas women’s decisions to receive a pap-test.
Academic/Professional Position
Staff
Recommended Citation
Puckett, Caroline; Garcia, Dolores; and Jones, Rebecca, "Social and Structural Determinants of Health Associated with Cervical Cancer Screening Uptake in South Texas" (2024). Research Symposium. 60.
https://scholarworks.utrgv.edu/somrs/2024/posters/60
Included in
Social and Structural Determinants of Health Associated with Cervical Cancer Screening Uptake in South Texas
Background: The Mays Cancer Center (MCC) is one of only four National Cancer Institute (NCI)-designated cancer centers in Texas and the only one in South Texas. The MCC serves 38 counties and over 4.9 million residents; 70% of residents are Hispanic, 25 of 38 counties are designated as rural areas; additionally, 25 of the 38 counties have census tracts designated as areas of persistent poverty. Catchment area residents are at disproportionately greater risk of developing liver and intrahepatic bile duct cancer (64%), cervical cancer (46%), gallbladder cancer (8%), gastric cancer (4%), and pediatric leukemia (32%) compared to the nation. Currently the Papanicolaou test (often called a pap test) is considered the most effective screening test for identifying abnormal cells associated with cervical cancer. During a pap-test, cervical cells are collected and examined for pre-cancerous or cancerous changes. When cancer is detected at an earlier stage, before symptoms start to appear, it is often easier to treat. For South Texas women, evidence suggests that barriers to receiving a pap-test include low health literacy, cultural beliefs and norms, and lack of health insurance coverage. Additionally, there is growing evidence that structural and social determinants of health (SDoH) also impact adherence to cancer screenings. The purpose of this study was to examine select SDoH that may be influencing South Texas women’s decisions to receive a pap test.
Methods: In the summer and fall of 2020, the MCC Community Outreach and Engagement team fielded the South Texas Survey. This survey captured information in seven specific domains, two of which are social determinants of health and cancer screening practices. This survey was designed using a probabilistic sampling frame for our catchment area with representation from a metropolitan and race and ethnicity perspective. A total of 555 individuals completed the survey of which 382 identified as female (69%). For this study, descriptive statistics and chi-square analysis were used to examine the study population. Generalized logistic regression were used to identify individual, social, and structural factors associated with cervical cancer screening uptake. All data were weighted, and analyses were conducted using the R statistical software.
Results: Overall, 80% of women indicated they had received a pap-test. When examining women who indicated not receiving a pap-test, a greater proportion were Hispanic, single and did not have health care coverage. For a SDoH perspective, regression results determined that at the individual level, single women had 89% lower odds of having received a pap-test compared to married women (OR: 0.11; CI: 0.03-0.42) and women who had a higher discrimination index score had 27% lower odds of having received a pap-test compared to women who had lower index scores (OR: 0.73; CI: 0.53-1.00). Conclusion: South Texas women who are single, report perceptions of greater discrimination, and/or do not have healthcare coverage are less likely to have a pap test. Results provide insight into the influence of social and structural determinants of health on South Texas women’s decisions to receive a pap-test.