Hispanic Ethnicity and Cervical Cancer Precursors Among Low-Income Women in Arizona

Figures & data

Table 1 Patient Characteristics by Ethnicity

Characteristics	Non-Hispanic Whites (n=2419)	Hispanics (n=8492)	Total (n=10,911)	P-value
Number of Visits: mean (SD)	2.05 (1.44)	2.35 (1.65)		p<0.001
Age: mean (SD)	51.9 (7.32)	48.1 (9.72)		p<0.001
Age: n (%)
10–29	27 (1.10)	186 (2.20)	213 (2.00)	p<0.001
30–49	883 (36.5)	4794 (58.8)	5677 (52.3)
≥50	1509 (62.4)	3512 (39.0)	5012 (45.7)
Smoking Status n (%)^a
Non-smoker	2283 (93.3)	8223 (96.8)	10,506 (96.2)	p<0.001
Smoker	136 (6.7)	269 (3.2)	405 (3.8)
Income n (%)^a
≤ $15,000	1148 (47.5)	5032 (60.4)	6180 (57.7)	p<0.001
> $15,001	1265 (52.5)	3438 (39.6)	4703 (42.3)
Household Size n (%)^a
≤ 3	2233 (92.7)	5935 (70.0)	8168 (75.0)	p<0.001
≥4	176 (7.3)	2540 (30.0)	2716 (25.0)
Prior Pap n (%)^a
Yes	2264 (93.6)	7869 (92.7)	10,133 (92.9)	p=0.211
No	130 (5.70)	518 (6.10)	648 (5.94)
Unknown	25 (0.7)	102 (1.20)	127 (1.16)
Birth Origin n (%)^a
United States	2102 (95.2)	700 (8.60)	2802 (27.0)	p<0.001
Mexico	106 (4.80)	7454 (91.4)	7560 (73.0)

Note: ^aIndicates missing value.

Table 2 Cervical Cytology: Associations with Socio-Demographics (n=10,911)

	Normal n=10,575 (96.92%)	Positive n=336 (3.08%)		LSIL n=275 (2.52%)		HSIL/ICC n=61 (0.56%)
	n (%)	n (%)	OR (95% CI)	n (%)	OR (95% CI)	n (%)	OR (95% CI)
Ethnicity
Non-Hispanic white (Ref)	2359 (97.5)	60 (2.48)	1.00	47 (1.99)	1.00	13 (0.49)	1.00
Hispanic	8216 (96.8)	276 (3.20)	1.32 (1.00–1.75)	228 (2.76)	1.39 (1.01–1.91)^a	48 (0.44)	1.06 (0.57–1.96)
Age^d
10–29 (Ref)	197 (93.4)	14 (6.64)	1.00	10 (4.74)	1.00	4 (1.90)	1.00
30–49	5332 (96.3)	207 (3.74)	0.57 (0.33–0.99)^a	166 (3.00)	0.61 (0.32–1.18)	41 (0.74)	0.38 (0.13–1.07)
≥50	4689 (97.8)	107 (2.23)	0.32 (0.18–0.57)^c	92 (1.92)	0.39 (0.20–0.75)^b	15 (0.31)	0.16 (0.05–0.48)^c
Smoking Status^d
Non-smoker (Ref)	10,187 (97.0)	138 (3.00)	1.00	116 (1.14)	1.00	22 (1.86)	1.00
Smoker	388 (95.8)	19 (4.20)	1.40 (0.85–2.30)	12 (3.10)	0.96 (0.52–1.76)	7 (1.10)	2.86 (1.23–6.70)^a
Income^d
≤ $15,000	5963 (96.5)	217 (3.49)	1.40 (1.12–1.75)^b	183 (2.96)	1.52 (1.18–1.95)^c	34 (0.55)	1.01 (0.61–1.65)
> $15,000 (Ref)	4584 (97.5)	119 (2.52)	1.00	92(1.96)	1.00	27 (0.57)	1.00
Household Size^d
≤ 3 (Ref)	8243 (97.0)	253 (3.00)	1.00	201 (2.37)	1.00	52 (0.6)	1.00
≥4	2698 (97.1)	80 (2.9)	1.03 (0.81–1.32)	56 (2.0)	0.94 (0.71–1.24)	24 (0.90)	1.49 (0.88–2.52)
Prior Pap^d
Yes (Ref)	9825 (97.0)	308 (3.04)	1.00	261 (2.58)	1.00	47 (0.46)	1.00
No	631 (97.4)	17 (2.62)	0.86 (0.53–1.41)	8 (1.23)	0.50 (0.26–0.97)^a	9 (1.39)	2.68 (1.03–4.42)^b
Unknown	116 (91.3)	11 (8.66)	3.02 (1.61–5.67)^b	6 (4.72)	2.10 (0.97–4.54)	5 (3.94)	7.99 (3.14–20.4)^c
Birth Origin^d
United States (Ref)	2898 (97.7)	69 (2.33)	1.00	55 (1.85)	1.00	14 (0.47)	1.00
Mexico	7320 (96.6)	259 (3.42)	1.49 (1.14–1.94)^b	213 (2.81)	1.53 (1.13–2.07)^b	46 (0.61)	1.30 (0.71–2.37)

Notes: ^ap<0.05; ^bp< 0.01; ^cp<0.001; ^dIndicates missing values.

Abbreviations: LSIL, Low-grade squamous intraepithelial lesion; HSIL, High grade squamous intraepithelial lesion.

Table 3 Factors Associated with Ethnicity (Non-Hispanic Whites/Hispanics) and Positive Pap Smear Results, LSIL & HSIL: Adjusted Models

	Model 1 aOR (95% CI) Positive vs Negative	Model 2 aOR (95% CI) LSIL vs Negative	Model 3 aOR (95% CI) HSIL vs Negative
Characteristic
Ethnicity
Non-Hispanic White (Ref)	1.00	1.00	1.00
Hispanic	0.99 (0.74–1.33)	1.04 (0.75–1.45)	0.85 (0.45–1.61)
Number of Visits	1.34 (1.28–1.41)^c	1.37 (1.30–1.44)^b	1.19 (1.04–1.36)^b
Age
10–29 (Ref)	1.00	1.00	1.00
30–49	0.49 (0.27–0.86)^a	0.52 (0.27–1.01)	0.38 (0.13–1.09)
≥50	0.28 (0.15–0.51)^c	0.32 (0.16–0.63)^b	0.15(0.05–0.48)^b
Smoking Status
Non-Smoking (Ref)	1.00	1.00	1.00
Smoker	1.44 (0.88–2.38)	1.14 (0.62–2.09)	2.88 (1.21–6.84)^a
Income
≤ $15,000	1.43 (1.13–1.80)^b	1.54 (1.30–1.44)^c	0.96 (0.58–1.60)
> $15,000 (Ref)	1.00	1.00	1.00
Household Size
≤3 (Ref)	1.00	1.00	1.00
>3	0.97 (0.75–1.25)	0.88 (0.66–1.17)	1.48 (0.85–2.58)
Prior Pap
Yes (Ref)	1.00	1.00	1.00
No	0.79 (0.47–1.34)	0.63 (0.31–1.30)	3.54 (1.61–6.99)^b
Unknown	3.16 (1.67–5.96)^c	2.86 (1.19–2.00)^a	9.33 (3.55–24.5)^c
Birth Origin
US (Ref)	1.00	1.00	1.00
Mexico	1.43 (0.90–2.27)	1.63 (0.97–2.74)	1.51(0.53–4.36)

Notes: Model 1. adjusted for age, number of visits, income, prior Pap history; model 2. adjusted for age, income and prior Pap history; model 3. adjusted for age, smoking status and prior Pap test history; ^ap<0.05, ^bp<0.01, ^c<0.001.

Abbreviations: aOR, adjusted odds ratio; US, United States; Ref, reference.