Can STD Clinics Reach Women in Need of Cervical Cancer Screening? If They Can, Does It Matter?

Background: Reducing cervical cancer disparities in the U.S. requires venues that can reach underscreened women who are often uninsured or members of racial and ethnic minority groups. This study evaluated the degree to which an urban STD clinic can reach women in need of cervical cancer screening and navigation to follow-up care.

Methods: Cervical cancer screening (cytology and co-testing for HPV DNA) was offered to 103 women >30 years old attending an urban, Midwestern STD clinic between June 2012-October 2013. Variables of interest were related to sociodemographics (age, race/ethnicity) and health system access (being insured, having a regular doctor, and time of last Pap smear). Navigation to colposcopy was based on high-risk HPV (hrHPV) and Pap testing outcomes. Participants who were hrHPV+ with a Pap result of ≥ASCUS were referred to colposcopy.

Results: Among the sample, 71.8% reported not having a regular doctor, and 76.2% did not have insurance. Over one third (35.9%) of the sample had not received a Pap in the last 3 years, and 22.3% reported not receiving a Pap in at least 5 years. 11.7% of participants had high-risk outcomes (hrHPV+ and Pap result of ≥ASCUS); 5.8% of participants were extremely high-risk (hrHPV+ and Pap result of ≥LSIL). 7% of African American women had extremely high-risk outcomes compared to 2.6% of white women.

Conclusions: Findings suggest that STD clinics may be good venues to offer cervical cancer screening and follow-up navigation because women served in these venues have high need for cervical cancer screening and navigation to follow-up care. This is likely due to the safety-net nature of STD clinics.