A comparison of cervical cancer screening rates among women with traumatic spinal cord injury and the general population

Abstract

Background: Previous qualitative and survey studies have suggested women with spinal cord injury (SCI) are screened less often for cervical cancer compared with the general population. We investigated whether cervical cancer screening rates differ between population-based women with and without traumatic SCI, matched for age and geography.

Methods: A double cohort design was used, comparing women with SCI to the general population (1:4) using administrative data for Ontario, Canada. Women with SCI, identified using the Discharge Abstract Database for the fiscal years 1995-1996 to 2001-2002, were female residents of Ontario between the ages of 25 and 66, admitted to an acute care facility with a traumatic SCI (ICD-9 CM code 806 or 952). Women in the general Ontario population were randomly matched by age and geography. Screening rates were calculated from fee codes related to Papanicolaou (Pap) smear tests for a 3-year period preinjury and postinjury.

Results: There were 339 women with SCI matched to 1506 women in the general Ontario population. Screening rates pre-SCI were 55% for women with SCI and 57% during this same time period for matched women in the general population; post-SCI rates were 58% for both the two groups. Factors predicting the likelihood of receiving a Pap test for SCI cases included younger age and higher socioeconomic status.

Conclusions: Utilization data suggest that there are no significant differences in screening rates for women with SCI compared with the general population. However, screening rates for women with SCI were significantly influenced by age as well as income.