TY - JOUR
T1 - Low Rate of Cervical Cancer Screening among Women with Hematologic Malignancies after Stem Cell Transplant
AU - Hwang, Jessica P.
AU - Ahmed, Sairah
AU - Ariza-Heredia, Ella J.
AU - Duan, Zhigang
AU - Zhao, Hui
AU - Schmeler, Kathleen M.
AU - Ramondetta, Lois
AU - Parker, Susan L.
AU - Suarez-Almazor, Maria E.
AU - Ferrajoli, Alessandra
AU - Shih, Ya Chen Tina
AU - Giordano, Sharon H.
AU - Chiao, Elizabeth Y.
N1 - Funding Information:
Financial disclosures: This research was supported by the Duncan Family Institute Seed Funding (to J.P.H.) and AIDS Malignancy Consortium at Dan L. Duncan Comprehensive Cancer Center at Baylor College of Medicine (grant P30CA125123-04S1 , to E.Y.C.). This work was also supported in part by resources provided by the National Institutes of Health through MD Anderson's Cancer Center Support Grant ( CA016672 ) and by the Center for Innovations in Quality, Effectiveness and Safety (grant CIN 13-413 ) at the Michael E. DeBakey Veterans Affairs Medical Center .
Funding Information:
Financial disclosures: This research was supported by the Duncan Family Institute Seed Funding (to J.P.H.) and AIDS Malignancy Consortium at Dan L. Duncan Comprehensive Cancer Center at Baylor College of Medicine (grant P30CA125123-04S1, to E.Y.C.). This work was also supported in part by resources provided by the National Institutes of Health through MD Anderson's Cancer Center Support Grant (CA016672) and by the Center for Innovations in Quality, Effectiveness and Safety (grant CIN 13-413) at the Michael E. DeBakey Veterans Affairs Medical Center.
Publisher Copyright:
© 2018 The American Society for Blood and Marrow Transplantation
PY - 2018/5
Y1 - 2018/5
N2 - Annual cervical cancer screening with Papanicolaou (Pap) and human papillomavirus (HPV) testing after stem cell transplant (SCT) is recommended, but the uptake is unknown. We aimed to determine the prevalence and predictors of cervical cancer screening in patients with hematologic malignancies. We searched MarketScan Commercial Claims database for women who underwent allogeneic or autologous SCT. The primary outcome was cervical cancer screening, defined as procedures or abnormal results for HPV and/or Pap testing according administrative codes within 2 years after SCT. A multivariable logistic regression model was fitted with cancer type, SCT year, age, geographic area, insurance plan, comorbidity, and presence of graft-versus-host disease (GVHD).The study included 1484 patients; 1048 patients (70.6%) had autologous and 436 (29.4%) allogeneic SCT. Mean age was 52.5 years. Overall, 660 patients (44.5%) had screening within 2 years after SCT, 214 (49.1%) with allogeneic SCT and 446 (42.6%) with autologous SCT (P =.02). In the allogeneic SCT group, patients with GVHD had a lower rate of screening than patients without GVHD (42.5% versus 55.4%, P <.01), and GVHD was associated with lower odds of screening (odds ratio,.50; 95% confidence interval,.32 to.79). In the autologous SCT group, patients with comorbid medical conditions had a lower rate of screening than patients without comorbidity (36.0% versus 45.7%, P <.01). In both allogeneic and autologous SCT groups older patients had lower odds of screening. Cervical cancer screening rates after SCT are low, particularly in patients with GVHD, who are at significant risk of second malignancies. Future work is needed to develop strategies to increase uptake.
AB - Annual cervical cancer screening with Papanicolaou (Pap) and human papillomavirus (HPV) testing after stem cell transplant (SCT) is recommended, but the uptake is unknown. We aimed to determine the prevalence and predictors of cervical cancer screening in patients with hematologic malignancies. We searched MarketScan Commercial Claims database for women who underwent allogeneic or autologous SCT. The primary outcome was cervical cancer screening, defined as procedures or abnormal results for HPV and/or Pap testing according administrative codes within 2 years after SCT. A multivariable logistic regression model was fitted with cancer type, SCT year, age, geographic area, insurance plan, comorbidity, and presence of graft-versus-host disease (GVHD).The study included 1484 patients; 1048 patients (70.6%) had autologous and 436 (29.4%) allogeneic SCT. Mean age was 52.5 years. Overall, 660 patients (44.5%) had screening within 2 years after SCT, 214 (49.1%) with allogeneic SCT and 446 (42.6%) with autologous SCT (P =.02). In the allogeneic SCT group, patients with GVHD had a lower rate of screening than patients without GVHD (42.5% versus 55.4%, P <.01), and GVHD was associated with lower odds of screening (odds ratio,.50; 95% confidence interval,.32 to.79). In the autologous SCT group, patients with comorbid medical conditions had a lower rate of screening than patients without comorbidity (36.0% versus 45.7%, P <.01). In both allogeneic and autologous SCT groups older patients had lower odds of screening. Cervical cancer screening rates after SCT are low, particularly in patients with GVHD, who are at significant risk of second malignancies. Future work is needed to develop strategies to increase uptake.
KW - Cervical cancer screening
KW - Human papillomavirus
KW - Second malignancies
KW - Stem cell transplant
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U2 - 10.1016/j.bbmt.2018.01.019
DO - 10.1016/j.bbmt.2018.01.019
M3 - Article
C2 - 29378304
AN - SCOPUS:85042357437
SN - 1083-8791
VL - 24
SP - 1094
EP - 1098
JO - Biology of Blood and Marrow Transplantation
JF - Biology of Blood and Marrow Transplantation
IS - 5
ER -