Prevalence and determinants of cervical cancer screening with a combination of cytology and human papillomavirus testing

Purpose: In the United States, recommended options for cervical cancer screening in women aged 30 years or older include cytology alone or a combination of cytology and human papillomavirus (HPV) testing (co-testing). Although there is a body of evidence suggesting that co-testing may be the preferred screening option in this group of women, little is known about the characteristics of women who screen for cervical cancer with co-testing. Methods: A multistage area probability design-based survey was administered to a representative sample of Texas residents. Of the 1348 female respondents, 572 women aged 30 years or older were included in this analysis. Population-weighted survey logistic regression was used to identify determinants of cervical screening with co-testing versus screening with cytology alone. Results: Women vaccinated against HPV (aOR: 4.48, 95% CI: 1.25–15.97) or hepatitis B virus [aOR: 2.48 (1.52–4.02)], those with a personal cancer history [aOR: 2.96 (1.29–6.77)], and hormonal contraception users [aOR: 2.03 (1.03–3.97)] were more likely to be screened with co-testing than with cytology alone. Moreover, the likelihood of being screened with co-testing decreased with increasing age and decreasing annual household income. Conclusions: Benefits and indications of co-testing should be better explained to women and health care providers.