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Time to clinical investigation for Indigenous and non-Indigenous Queensland women after a high grade abnormal pap smear, 2000-2009.

Affiliation(s)

(Whop, Cunningham, Garvey, Moore, Diaz, Condon) Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
(Baade) Cancer Research Centre, Cancer Council Queensland, Brisbane, QLD, Australia
(Brotherton) Victorian Cytology Service, Melbourne, VIC, Australia
(Canfell, O'Connell) Cancer Research Division, Cancer Council NSW, Sydney, NSW, Australia
(Gertig) Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
(Lokuge) ANU College of Medicine, Biology and Environment, Australian National University, Canberra, ACT, Australia
(Valery) QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
(Roder) Centre for Population Health Research, University of South Australia, Adelaide, SA, Australia

Year

2017

Citation

Medical Journal of Australia. Vol.206(2), 2017, pp. 73-77.

Journal

Medical Journal of Australia

Conference name

Conference location

Grant information

No: 04559 Organisation: (NHMRC) National Health and Medical Research Council
Lisa Whop was supported b ya Sidney Myer Health scholarship, a Menzies Enhanced Living scholarship, and a Lowitja Institute scholarship

Abstract

Objectives: To investigate time to follow-up (clinical investigation) for Indigenous and non-Indigenous women in Queensland after a high grade abnormality (HGA) being detected by Pap smear. Design, setting, participants: Population-based retrospective cohort analysis of linked data from the Queensland Pap Smear Register (PSR), the Queensland Hospital Admitted Patient Data Collection, and the Queensland Cancer Registry. 34 980 women aged 20e68 years (including 1592 Indigenous women) with their first HGA Pap smear result recorded on the PSR (index smear) during 2000e2009 were included and followed to the end of 2010. Main Outcome Measure(s): Time from the index smear to clinical investigation (histology test or cancer diagnosis date), censored at 12 months. Result(s): The proportion of women who had a clinical investigation within 2 months of a HGA finding was lower for Indigenous (34.1%; 95% CI, 31.8e36.4%) than for non-Indigenous women (46.5%; 95% CI, 46.0e47.0%; unadjusted incidence rate ratio [IRR], 0.65; 95% CI, 0.60e0.71). This difference remained after adjusting for place of residence, area-level disadvantage, and age group (adjusted IRR, 0.74; 95% CI, 0.68e0.81). However, Indigenous women who had not been followed up within 2months were subsequently more likely to have a clinical investigation than non-Indigenous women (adjusted IRR for 2e4 month interval, 1.21; 95% CI, 1.08e1.36); by 6 months, a similar proportion of Indigenous (62.2%; 95% CI, 59.8e64.6%) and non-Indigenous women (62.8%; 95% CI, 62.2e63.3%) had been followed up. Conclusion(s): Prompt follow-up after a HGA Pap smear finding needs to improve for Indigenous women. Nevertheless, slow follow-up is a smaller contributor to their higher cervical cancer incidence and mortality than their lower participation in cervical screening.Copyright ©2017 AMPCo Pty Ltd. Produced with Elsevier B.V. All rights reserved.

PubMed ID

28152354 [https://www.ncbi.nlm.nih.gov/pubmed/?term=28152354]

Type

Article

Study type

Subjects

Cancer

Keywords