Cervical cancer screening and prevention among Latinas in the U.S. among a network of community health centers

Introduction: Timely cervical cancer screenings are critical for middle to older aged Latinas, who have high morbidity and mortality from cervical cancer, but we currently know less about screening in this population. Efforts to engage middle to older-age Latina immigrants need to be tailored to recognize their distinct experiences with coming to the US that may set them apart from other groups. Latinas tend to receive disproportionate care in Community Health Centers (CHCs) and CHCs are a vital component for cancer screening and prevention. This study leverages a national network of CHCs to assess disparities in and utilization of cervical cancer screening among middle to older age Latinas. Methods: Retrospective analysis of electronic health record data from a multistate network of CHCs across the United States. Data were extracted on Latina and non-Hispanic White (NHW) women age >45 with known birth country and at least one in-person primary care visit in a CHC between January 1, 2014, and September 14, 2022, across 527 community-based primary care clinics in 15 states. To examine the receipt of at least one Pap Smear and/or Human papilloma Varus (HPV) test ever during the study period, generalized estimating equations (GEE) logistic regression were conducted, overall and disaggregated by country of origin. Results: Among 34,135 patients, we found that all Latina groups aside from US born Latinas and those from other countries with sample sizes too small to analyze individually had higher odds of receiving either an HPV or Pap test compared to non-Hispanic Whites. When disaggregated by country of origin, all Latina groups born in Central America have higher odds than non-Hispanic Whites. All three of the models showed that Latinas had higher odds of receiving either an HPV or Pap test at least once during the study period compared to non-Hispanic White patients. Conclusion: CHCs may have unique strengths to address diverse and underserved populations such as Latinas; however, rates remain less than optimal, and work is still needed