Cervical abnormalities are more common among Indigenous than other Australian women: a retrospective record-linkage study, 2000-2011.
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Date
2016-04-22
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Affiliation(s)
(Whop, Garvey, Cunningham, Valery, Diaz, Moore, Condon) Epidemiology and Health Systems Division, Menzies School of Health Research, Charles Darwin University, Darwin, Brisbane, Australia
(Baade) Cancer Council Queensland, Brisbane, Australia
(Brotherton) Victorian Cytology Service Inc, Melbourne, VIC, Australia
(Brotherton, Gertig) School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
(Lokuge) National Centre of Epidemiology and Public Health, Australian National University, Canberra, Australia
(Valery) QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
(O'Connell, Canfell) Cancer Research Division, Cancer Council New South Wales, Sydney, NSW, Australia
(O'Connell, Canfell) School of Public Health, University of Sydney, Sydney, NSW, Australia
(O'Connell) School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia
(Roder) Centre for Population Health Research, University of South Australia, Adelaide, SA, Australia
(Baade) Cancer Council Queensland, Brisbane, Australia
(Brotherton) Victorian Cytology Service Inc, Melbourne, VIC, Australia
(Brotherton, Gertig) School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia
(Lokuge) National Centre of Epidemiology and Public Health, Australian National University, Canberra, Australia
(Valery) QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
(O'Connell, Canfell) Cancer Research Division, Cancer Council New South Wales, Sydney, NSW, Australia
(O'Connell, Canfell) School of Public Health, University of Sydney, Sydney, NSW, Australia
(O'Connell) School of Medicine and Public Health, University of Newcastle, Newcastle, NSW, Australia
(Roder) Centre for Population Health Research, University of South Australia, Adelaide, SA, Australia
Year
2016
Citation
PLoS ONE. Vol.11(4), 2016.
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PLoS ONE
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Organisation: Lowitja Institute
No: 1041111 Organisation: (NHMRC) Lowitja Institute
No: SRP13-01 Organisation: Lowitja Institute
Lisa J Whop is supported by a Sidney Myer Health Scholarship, Menzies Enhanced Living Top-up and a student scholarship funded by the Lowitja Institute.
No: 1041111 Organisation: (NHMRC) Lowitja Institute
No: SRP13-01 Organisation: Lowitja Institute
Lisa J Whop is supported by a Sidney Myer Health Scholarship, Menzies Enhanced Living Top-up and a student scholarship funded by the Lowitja Institute.
Abstract
Indigenous Australian women have much higher incidence of cervical cancer compared to non-Indigenous women. Despite an organised cervical screening program introduced 25 years ago, a paucity of Indigenous-identified data in Pap Smear Registers remains. Prevalence of cervical abnormalities detected among the screened Indigenous population has not previously been reported. We conducted a retrospective cohort study of populationbased linked health records for 1,334,795 female Queensland residents aged 20-69 years who had one or more Pap smears during 2000-2011; from linked hospital records 23,483 were identified as Indigenous. Prevalence was calculated separately for Indigenous and non-Indigenous women, for cytology-detected low-grade (cLGA) and highgrade abnormalities (cHGA), and histologically confirmed high-grade abnormalities (hHGA). Odds ratios (OR) were estimated from logistic regression analysis. In 2010-2011 the prevalence of hHGA among Indigenous women (16.6 per 1000 women screened, 95% confidence interval [CI] 14.6-18.9) was twice that of non-Indigenous women (7.5 per 1000 women screened, CI 7.3-7.7). Adjusted for age, area-level disadvantage and place of residence, Indigenous women had higher prevalence of cLGA (OR 1.4, CI 1.3-1.4), cHGA (OR 2.2, CI 2.1-2.3) and hHGA (OR 2.0, CI 1.9-2.1). Our findings show that Indigenous women recorded on the Pap Smear Register have much higher prevalence for cLGA, cHGA and hHGA compared to non-Indigenous women. The renewed cervical screening program, to be implemented in 2017, offers opportunities to reduce the burden of abnormalities and invasive cancer among Indigenous women and address long-standing data deficiencies.Copyright © 2016 Whop et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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Article
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Cancer