Table 3.
Demographic Characteristics, Risk Factors, and Select Screening Process Measures at Baseline in the Cervical PROSPR I Research Centers
| Kaiser Permanente Washington | Kaiser Permanente | Parkland Health & Hospital System-University of Texas Southwestern | University of New Mexico – New Mexico HPV Pap Registry | ||
|---|---|---|---|---|---|
| Northern California | Southern California | ||||
| Cohort Definition | 18 to 89-year-old females enrolled in the Group Practice Division of the health plan at any time during January 1, 2010 through December 31, 2014 | 18 to 89-year-old females enrolled in the health plan at any time during January 1, 2010 through December 31, 2013 | 18 to 64-year-old female Dallas County residents with a primary care clinic or women’s health center visit at any time during January 1, 2010 through September 30, 2014 | 18 to 89-year-old females residing in New Mexico who underwent cervical cancer screening, diagnosis, or treatment any time during January 1, 2012 through June 30, 2014 | |
| Total population in baseline yeara | 207,999 | 1,402,797 | 1,468,883 | 84,253 | 800,220 |
| Demographics and Risk Factors | n (%) | n (%) | n (%) | n (%) | n (%) |
| Age in yearsa | |||||
| 18–20 | 12,982 (6.2) | 89,685 (6.4) | 107,507 (7.3) | 4,455 (5.3) | 43,020 (5.4) |
| 21–29 | 31,076 (14.9) | 206,143 (14.7) | 233,488 (15.9) | 21,363 (25.4) | 126,667 (15.8) |
| 30–39 | 33,227 (16.0) | 248,536 (17.7) | 263,112 (17.9) | 23,446 (27.8) | 126,446 (15.8) |
| 40–49 | 37,003 (17.8) | 261,071 (18.6) | 278,065 (18.9) | 16,045 (19.0) | 129,365 (16.2) |
| 50–59 | 43,630 (21.0) | 259,170 (18.5) | 269,701 (18.4) | 13,348 (15.8) | 148,006 (18.5) |
| 60–65b | 21,149 (10.2) | 126,285 (9.0) | 125,313 (8.5) | 5,596 (6.6) | 78,674 (9.8) |
| 66–89 | 28,932 (13.9) | 211,907 (15.1) | 191,697 (13.1) | --- | 148,042 (18.5) |
| Race/ethnicitya | |||||
| Non-Hispanic white | 127,322 (75.0) | 699,530 (54.3) | 510,010 (38.9) | 7,560 (9.0) | 354,942 (44.4) |
| Non-Hispanic black | 7,821 (4.6) | 107,178 (8.3) | 142,590 (10.9) | 21,171 (25.2) | 12,300 (1.5) |
| Hispanic | 9,522 (5.6) | 236,735 (18.4) | 492,979 (37.6) | 52,594 (62.6) | 344,253 (43.0) |
| Asian/Pacific Islander | 17,192 (10.1) | 237,785 (18.5) | 138,436 (10.5) | 2,491 (3.0) | 13,400 (1.7) |
| Native American/Alaskan Native | 1,427 (0.8) | 4,701 (0.4) | 2,428 (0.2) | 97 (0.1) | 66,549 (8.3) |
| Other/Multiracial | 6,529 (3.8) | 2,197 (0.2) | 26,270 (2.0) | 74 (0.1) | 8,776 (1.1) |
| Unknown | 38,186 | 114,671 | 156,170 | 266 | 0 |
| Rural-Urban Continuum measurec | |||||
| Metropolitan | 199,644 (96.6) | 1,338,896 (95.9) | 1,447,722 (98.7) | 84,253 (100) | 523,608 (65.4) |
| Micropolitan | 4,993 (2.4) | 38,734 (2.8) | 15,900 (1.1) | 0 (0.0) | 196,465 (24.6) |
| Low density | 2,050 (1.0) | 18,975 (1.4) | 3,513 (0.2) | 0 (0.0) | 80,147 (10.0) |
| Unknown | 1,312 | 6,192 | 1,748 | 0 | 0 |
| Health Insuranced, e | |||||
| Medicaid | 5,942 (2.9) | 32,160 (2.3) | 42,037 (2.9) | 16,006 (19.1) | --- |
| Medicare | 35,873 (17.2) | 287,470 (20.5) | 208,285 (14.2) | 2,907 (3.5) | --- |
| Commercial/Private | 159,969 (76.9) | 1,082,391 (77.2) | 1,218,420 (83.0) | 4,401 (5.3) | --- |
| Other Government | 6,215 (3.0) | 0 (0.0) | 0 (0.0) | 25,770 (30.7) | --- |
| Uninsured/Charity | 0 (0.0) | 0 (0.0) | 0 (0.0) | 34,721 (41.4) | --- |
| Unknown | 0 | 776 | 141 | 448 | --- |
| Absent cervix documented in EHRd, f | 18,123 (8.7) | 119,252 (8.5) | 147,516 (10.0) | 4,351 (5.2) | --- |
| Prior cervical cancer diagnosisd | 421 (0.2) | 1,150 (0.1) | 994 (0.1) | 218 (0.3) | --- |
| HIV positived | 221 (0.1) | 715 (0.1) | 632 (0.0) | 1,044 (1.2) | --- |
| Prior HPV vaccinationsd | |||||
| None | 194,681 (93.6) | 1,344,929 (95.9) | 1,367,805 (93.1) | 83,959 (99.7) | --- |
| 1 or more doses | 13,318 (6.4) | 57,868 (4.1) | 101,078 (6.9) | 294 (0.3) | --- |
| Screening Process Measures in Baseline Year | 2010 | 2012 | |||
| n (%) | n (%) | n (%) | n (%) | n (%) | |
| Vaccinatedd, g | 1,318 (7.0) | 3,242 (2.2) | 10,837 (7.2) | 16 (0.1) | --- |
| Cytology testedh | 49,525 (26.1) | 338,479 (26.1) | 363,760 (27.1) | 28,822 (36.1) | 189,910 (30.4) |
| hrHPV testedh, i | 1,773 (0.9) | 274,932 (21.2) | 288,540 (21.5) | 5,094 (6.4) | 39,508 (6.3) |
| Reflex | 1,329 (82.8) | 11,902 (4.3) | 5,584 (2.1) | 635 (12.5) | 9,386 (23.3) |
| Co-test | 215 (13.4) | 263,030 (95.7) | 268,513 (97.9) | 4,173 (81.8) | 27,393 (67.9) |
| Other | 61 (3.8) | 0 (0.0) | 0 (0.0) | 286 (5.7) | 2,050 (5.1) |
| Unknown | 168 | 0 | 14,443 | 0 | 679 |
| Evaluated with colposcopyh, j | 2,579 (1.4) | 16,781 (1.3) | 17,402 (1.3) | 2,854 (3.6) | 8,999 (1.4) |
| Incident cervical cancer diagnosish, k | 15 (0.009) | 85 (0.007) | 111 (0.008) | 23 (0.029) | 66 (0.011) |
Abbreviations: EHR, electronic health record; HPV, human papillomavirus; hrHPV, high-risk HPV; UNM-NMHPVPR, University of New Mexico-New Mexico HPV Pap Registry.
Data source for UNM-NMHPVPR is United States Census data. All census records coded as Hispanic are aggregated in the Hispanic column. All other race groups represent counts for non-Hispanics. This coding of Hispanic deviates from race/ethnicity coding previously reported using New Mexico census data but is consistent with race/ethnicity construction for other PROSPR I Research Centers. Due to limitations in how age is presented in census data, race/ethnicity counts are reported for all women from New Mexico over the age of 18 as estimated for 2012.
Age group for Parkland Health & Hospital System-University of Texas Southwestern (Parkland-UTSW) cohort is 60- to 64-year-olds because of cohort eligibility criteria.
Rural-Urban Commuting Area (RUCA) frequencies for UNM-NMHPVPR were constructed from census 5-year population estimates by age, gender, and ZIP Code Tabulation Areas for the period ending in 2012. Percentages from census 5-year population estimates were applied to the 2012 census population totals reported for age and race/ethnicity to produce RUCA population estimates.
Information was not available for UNM-NMHPVPR.
Individuals in multiple insurance categories were categorized according to the following hierarchy: Medicaid, Medicare, commercial/private, other government (block grants that support cervical cancer screening at Parkland Health & Hospital System and the Basic Health Program in Washington State), uninsured/charity, and unknown.
Includes women who had EHR documentation of the following surgeries prior to cohort entry: pelvic exenteration, radical hysterectomy, total hysterectomy, trachelectomy/cervicectomy, and hysterectomy, not otherwise specified.
Eligible population (denominator) includes women age-eligible to receive the vaccine (18–26 years) who were not vaccinated prior to cohort entry.
At-risk populations (denominators) for Kaiser Permanente Washington (KPWA), Northern California, and Southern California; and Parkland-UTSW identified by excluding women with an absent cervix or history of invasive cervical cancer. At-risk population at UNM-NMHPVPR obtained by multiplying the estimate of the percentage of women with intact cervix (1 minus the percentage of women with absent cervix [0.219] as estimated from the 2012 Behavioral Risk Factor Surveillance System) with the census population estimate.
HPV test indication frequencies were calculated among those who were hrHPV tested. HPV test indication for UNM-NMHPVPR was assigned using an algorithmic approach: HPV tests ≤28 days following a Pap test were considered reflex or co-tests. HPV tests >28 days following a Pap test were considered to have other indications. HPV tests with unknown indication were without any preceding Pap test.
Colposcopies for UNM-NMHPVPR are restricted to those with biopsies or excisions.
Denominator for KPWA is also restricted to women residing in a Seattle-Puget Sound Surveillance, Epidemiology, and End Results county for the entire baseline year.