Table 1. Clinical and Demographic Characteristics of the Cohort.
| Characteristic | Initial cohort, No. (%) (N = 2 299 177) | Cohort with 3 y of follow-up | |||
|---|---|---|---|---|---|
| No. (%) | P value | Multivariable models of testing overuse, aOR (95% CI) | |||
| No overuse of cervical screening tests (n = 399 077) | Overuse of cervical screening tests (n = 732 501) | ||||
| Age, y | |||||
| 30-39 | 604 358 (26.3) | 92 449 (32.2) | 194 665 (67.8) | <.001 | 1 [Reference] |
| 40-49 | 742 827 (32.3) | 129 827 (34.3) | 249 088 (65.7) | 0.89 (0.88-0.90)a | |
| 50-59 | 746 852 (32.5) | 155 546 (37.7) | 256 550 (62.3) | 0.73 (0.72-0.73)a | |
| 60-64 | 205 140 (8.9) | 21 255 (39.8) | 32 198 (60.2) | 0.63 (0.62-0.64)a | |
| Year of index test | |||||
| 2013 | 1 722 141 (74.9) | 244 938 (30.6) | 555 767 (69.4) | <.001 | 1 [Reference] |
| 2014 | 577 036 (25.1) | 154 139 (46.6) | 176 734 (53.4) | 0.61 (0.60-0.61)a | |
| Type of index test | |||||
| Cotesting | 991 583 (43.1) | 210 089 (43.1) | 277 032 (56.9) | <.001 | 1 [Reference] |
| Cytologic | 1 286 179 (55.9) | 182 479 (28.8) | 450 438 (71.2) | 1.86 (1.85-1.88)a | |
| HPV testing | 21 415 (0.9) | 6509 (56.4) | 5031 (43.6) | 0.63 (0.61-0.66)a | |
| Metropolitan statistical area | |||||
| Yes | 1 961 975 (85.3) | 347 639 (35.3) | 638 320 (64.7) | .58 | 1 [Reference] |
| No | 290 262 (12.6) | 50 255 (35.3) | 91 942 (64.7) | 0.83 (0.82-0.84)a | |
| Unknown | 46 940 (2.0) | 1183 (34.6) | 2239 (65.4) | 1.22 (0.86-1.71) | |
| Region | |||||
| Northeast | 465 283 (20.2) | 67 353 (31.9) | 143 916 (68.1) | <.001 | 1 [Reference] |
| North Central | 438 605 (19.1) | 87 337 (41.3) | 124 166 (58.7) | 0.58 (0.57-0.58)a | |
| South | 973 383 (42.3) | 166 705 (30.5) | 380 530 (69.5) | 0.91 (0.90-0.92)a | |
| West | 374 680 (16.3) | 76 443 (48.4) | 81 552 (51.6) | 0.47 (0.46-0.48)a | |
| Unknown | 47 226 (2.1) | 1239 (34.6) | 2337 (65.4) | 0.56 (0.40-0.78)a | |
| Comorbidity score | |||||
| 0 | 1 301 469 (56.6) | 230 388 (35.3) | 423 012 (64.7) | <.001 | 1 [Reference] |
| 1 | 98 498 (34.8) | 184 292 (65.2) | 0.94 (0.93-0.95)a | ||
| ≥2 | 423 168 (18.4) | 70 191 (35.9) | 125 197 (64.1) | 0.85 (0.84-0.86)a | |
| Mental health or substance abuse | 230 742 (10.0) | 37 574 (36.5) | 65 380 (63.5) | <.001 | 0.81 (0.80-0.83)a |
| Outpatient visits within 12 mo prior, No. | |||||
| 0-2 | 924 734 (40.2) | 196 794 (41.3) | 279 412 (58.7) | <.001 | 1 [Reference] |
| 3-5 | 653 262 (28.4) | 105 142 (32.9) | 214 579 (67.1) | 1.32 (1.30-1.33)a | |
| >6 | 721 181 (31.4) | 97 141 (28.9) | 238 510 (71.1) | 1.60 (1.59-1.62)a | |
| Sexually transmitted disease within 12 mo prior | 1856 (0.1) | 199 (24.6) | 609 (75.4) | <.001 | 1.42 (1.21-1.68)a |
| Pregnancy within 12 mo prior | 85 753 (3.7) | 11 819 (29.5) | 28 210 (70.5) | <.001 | 0.95 (0.92-0.97)a |
| Gynecologic symptoms within 30 d of test | 136 833 (6.0) | 22 771 (35.3) | 41 824 (64.7) | .93 | 0.97 (0.95-0.99)a |
| Sexually transmitted disease testing within 12 mo prior | 353 417 (15.4) | 56 407 (34.1) | 109 193 (65.8) | <.001 | 1.07 (1.06-1.08)a |
| Family planning within 30 d of test | 86 521 (3.8) | 14 279 (37.0) | 24 335 (63.0) | <.001 | 0.91 (0.89-0.93)a |
Abbreviations: aOR, adjusted odds ratio; HPV, human papillomavirus.
a
P < .05.