Ohio Appalachian women's perceptions of the cost of cervical cancer screening

Authors

  • Ann Scheck McAlearney ScD, MS,

    Corresponding author
    1. Division of Health Services Management and Policy, College of Public Health, Ohio State University, Columbus, Ohio
    2. Center for Population Health and Health Disparities, Comprehensive Cancer Center, Ohio State University, Columbus, Ohio
    • Division of Health Services Management and Policy, College of Public Health, The Ohio State University, 174 W 18th Avenue, Smith Laboratory 5054, Columbus, OH 43210
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    • Fax: (614) 438-6859

  • Paula H. Song PhD, MHSA,

    1. Division of Health Services Management and Policy, College of Public Health, Ohio State University, Columbus, Ohio
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  • Dale A. Rhoda MAS, MS, MPP,

    1. Center for Population Health and Health Disparities, Comprehensive Cancer Center, Ohio State University, Columbus, Ohio
    2. Center for Biostatistics, Ohio State University, Columbus, Ohio
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  • Cathy Tatum MA,

    1. Center for Population Health and Health Disparities, Comprehensive Cancer Center, Ohio State University, Columbus, Ohio
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  • Stanley Lemeshow PhD,

    1. Center for Population Health and Health Disparities, Comprehensive Cancer Center, Ohio State University, Columbus, Ohio
    2. Center for Biostatistics, Ohio State University, Columbus, Ohio
    3. Division of Biostatistics, College of Public Health, Ohio State University, Columbus, Ohio
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  • Mack Ruffin MD, MPH,

    1. Department of Family Medicine, School of Medicine, University of Michigan, Ann Arbor, Michigan
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  • J. Phil Harrop MHA, MBA,

    1. Division of Health Services Management and Policy, College of Public Health, Ohio State University, Columbus, Ohio
    2. Center for Population Health and Health Disparities, Comprehensive Cancer Center, Ohio State University, Columbus, Ohio
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  • Electra D. Paskett PhD

    1. Center for Population Health and Health Disparities, Comprehensive Cancer Center, Ohio State University, Columbus, Ohio
    2. Division of Epidemiology, College of Public Health, Ohio State University, Columbus, Ohio
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  • This research was peer-reviewed and accepted for 2 poster presentations: the 2008 AcademyHealth Annual Research Meeting, Washington, DC, June 8, 2008; and the USC/NIH Conference: Interdisciplinary Science, Institute for Health Promotion and Disease Prevention, Pasadena, California, May 3, 2007.

Abstract

BACKGROUND:

Despite evidence of the importance of cervical cancer screening, screening rates in the United States remain below national prevention goals. Women in the Appalachia Ohio region have higher cervical cancer incidence and mortality rates along with lower cancer screening rates. This study explored the expectations of Appalachian Ohio women with regard to Papanicolaou (Pap) test cost and perceptions of cost as a barrier to screening.

METHODS:

Face-to-face interviews were conducted with 571 women who were part of a multilevel, observational community-based research program in Appalachia Ohio. Eligible women were identified through 14 participating health clinics and asked questions regarding Pap test cost and perceptions of cost as a barrier to screening. Estimates of medical costs were compared with actual costs reported by clinics.

RESULTS:

When asked about how much a Pap test would cost, 80% of the women reported they did not know. Among women who reportedly believed they knew the cost, 40% overestimated test cost. Women who noted cost as a barrier were twice as likely to not receive a test within screening guidelines as those who did not perceive a cost barrier. Furthermore, uninsured women were more than 8.5 times as likely to note cost as a barrier than women with private insurance.

CONCLUSIONS:

Although underserved women in need of cancer screening commonly report cost as a barrier, the findings of the current study suggest that women may have a very limited and often inaccurate understanding concerning Pap test cost. Providing women with this information may help reduce the impact of this barrier to screening. Cancer 2010. © 2010 American Cancer Society.

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