Factors associated with a lack of pap smear utilisation in women exposed in utero to diethylstilbestrol

The higher risk group of DES-exposed women need early detection of cervical and vaginal adenocarcinomas

pap-smear-kit
DES exposure, not having a previous gynecologic dysplasia diagnosis, lack of insurance, originating cohort, increasing age, and previous screening behavior were all factors associated with not reporting a Pap smear examination in the 2006 questionnaire. Colposcopy equipment image by stacya.

2015 Study Abstract

BACKGROUND:
Women in the 1940s-1960s were prescribed Diethylstilbestrol (DES), a nonsteroidal estrogen, to prevent miscarriages, but the practice was terminated after it was discovered that the daughters so exposed in utero were at increased risk for developing clear cell adenocarcinoma (CCA) of the vagina or cervix at early ages. Pap smear screening is one of the principal methods used to identify tumor development and is necessary in this group of women to maintain their health. Currently, little is known about the factors associated with nonutilization of this screening tool in this high-risk population of women.

METHODS:
National cohort data from the National Cancer Institute (NCI) DES Combined Cohort Follow-up Study during 1994, 1997, 2001, and 2006 were used to determine which factors were associated with Pap smear screening nonutilization in 2006 among DES-exposed and unexposed women. Self-reported questionnaire data from 2,861 DES-exposed and 1,027 unexposed women were analyzed using binary logistic regression models.

RESULTS:
DES exposure, not having a previous gynecologic dysplasia diagnosis, lack of insurance, originating cohort, increasing age, and previous screening behavior were all factors associated with not reporting a Pap smear examination in the 2006 questionnaire, although college education reduced nonutilization.

CONCLUSIONS:
Understanding which factors are associated with not acquiring a screening exam can help clinicians better identify which DES-exposed women are at risk for nonutilization and possibly tailor their standard of care to aid in the early detection of cervical and vaginal adenocarcinomas in this high-risk group.

Sources
  • Factors associated with a lack of pap smear utilization in women exposed in utero to diethylstilbestrol, NCBI PMID: 25768943, J Womens Health (Larchmt). 2015 Apr;24(4):308-15. doi: 10.1089/jwh.2014.4930. Epub 2015 Mar 13.
More DES DiEthylStilbestrol Resources

Review calls for urgent change to perception of cervical cancer risk in older women

Cervical cancer is not just a young woman’s disease…

pap-test
Pap tests are currently recommended for all women aged 21-65 though the authors of the review question whether screening should stop there. Routine Pap image by Ed Uthman.

Cervical screening programmes in many countries stop at around the age of 65 and much of the focus is often on younger women. For example, recent media campaigns in England and Wales have centred on lowering the age at first screening. Comparatively little attention has been given to older women despite the fact that they account for about a fifth of cases each year and half of deaths. Of the 3121 women diagnosed on average each year between 2009 and 2011 in the UK, only 64 were younger than 25 compared with 616 who were older than 65. As the population ages, this number of older women affected is set to increase. Susan Sherman and colleagues argue that screening programmes should reflect this.

Sources and more information

Cervical Cancer Screening with the HPV test and Pap Test

When to Get Tested and How to Make Sense of Your Test Results

Cervical-Cancer-Screening cover image
When to Get Tested and How to Make Sense of Your Test Results.

Sources and more information

On Flickr®

Smear Test Invitation Overdue?

a @JoTrust Poster – #CervicalCancer #PAPsmear

smear-test-invitation-overd
Smear Test Invitation Overdue? Image via @JoTrust.
Watch @DES_Journal diaporama and health posters album on Flickr.

On Flickr®

Preventing Cervical Cancer Infographic

Prevent Cervical Cancer with the Right Test at the Right Time

prevent-cervical-cancer infographic
Prevent Cervical Cancer with the Right Test at the Right Time.
Watch @DES_Journal diaporama and infographics album on Flickr. Image via @CDC_Cancer.

On Flickr®

Le Frottis, dépliant d’information – dépistage du cancer du col de l’utérus

A effectuer tous les trois ans, dès 25 ans et jusqu’à 65 ans

Dépliant-d'information-sur-cancer du col de l’utérus
En cohérence avec le Plan cancer 2014-2019, cette campagne INCa rappelle que le frottis doit être réalisé tous les trois ans, dès 25 ans et jusqu’à 65 ans.

A l’occasion de la 9ème semaine européenne de prévention et de dépistage du cancer du col de l’utérus, l’Institut national du cancer INCa et le ministère des Affaires sociales et de la Santé lancent, en partenariat avec les caisses d’assurance maladie, une nouvelle campagne de sensibilisation au dépistage de ce cancer pour rappeler l’importance d’un frottis régulier...

En savoir plus

Sur Flickr®

Cervical Cancer, a Prevention Success Story

Cervical cancer infographic via @preventcancer

InfoGraphic of Cervical Cancer
Watch @DES_Journal diaporama and infographics album on Flickr. Cervical cancer infographic via @preventcancer.

On Flickr®

What do Women think about the PAP Smear Test?

Jo’s Cervical Cancer Trust asked women what they think of cervical screening, how they found the test, and whether they would attend their next smear test…

Jo’s Cervical Cancer Trust asked women what they think of cervical screening, how they found the test, and whether they would attend their next smear test…

More information

I’ll have the PAP Smear… a @cbscares cartoon #CervicalCancer #CCPW #PAPsmear

Watch @DES_Journal diaporama and health comics album on Flickr. Cartoon via @cbscares.

cartoon_pap_smear
UK Cervical Cancer Prevention Week: 25 – 31 January 2015
Watch @DES_Journal diaporama and health comics album on Flickr. Cartoon via @cbscares.

This project on pap smears started during dinner at Il Mulino, a well known Italian restaurant in Manhattan’s West Village…

On Flickr®

Join Now @JoTrust #SmearForSmear social media campaign

Reminding people of the importance of smear tests by sharing your lipstick smear selfie for Cervical Cancer Prevention Week

What is #SmearForSmear?

SmearForSmear campaign image
With #SmearForSmear we want you to remind people of the importance of smear tests by sharing your lipstick smear selfie for Cervical Cancer Prevention Week #CCPW.

Smear tests (cervical screening) save 5,000 lives a year yet one in five women who are eligible to attend do not take up their invitation.
For young women aged 25-29 this rises to one in three.
#SmearForSmear allows you to remind people of the importance of smear tests by sharing your lipstick smear selfie and nominating your friends to do the same.

Together we can help prevent cervical cancer.

  1. Put on your lipstick.
  2. Smear your lipstick and take a selfie.
  3. Use #SmearForSmear and @JoTrust then nominate a friend.
  4. Share your selfie on social media.
  5. Text ‘CCPW01 £3‘ to 70070 to donate now and support jostrust work. Or donate online.
More information
  • Results for #SmearForSmear on Twitter. JoTrust campaign page.
  • Cervical cancer: Charity urges women to post messy lipstick selfies to promote smear tests, independent, 25 January 2015.
  • #SmearForSmear: Charity urges public to join smeared lipstick selfies campaign to fight cervical cancer, itv, 25 January 2015.
  • Social Media Campaign To Fight Cervical Cancer, news.sky, 26 January 2015.
  • ARE SMEARED LIPSTICK SELFIES THE NEW ICE BUCKET CHALLENGE?, Elle, JAN 27, 2015.