Is there a relationship between Religious Affiliation and Adherence to Recommended Cervical Cancer Screening Guidelines?

dc.creatorKrenek, Brittanyen_US
dc.creatorAkpan, Idaraen_US
dc.creatorBalasundaram, Rohiten_US
dc.creatorThompson, Erikaen_US
dc.creatorLuningham, Justin M.en_US
dc.descriptionResearch Appreciation Day Award Winner - School of Public Health, 2024 Research Award - 1st Placeen_US
dc.description.abstractPurpose: Cervical cancer is a preventable disease that, despite growing research and health advancements, remains a public health concern in the United States (US).The United States Preventative Services Task Force (USPSTF) recommends cervical cancer screenings (CCS) for individuals with a cervix aged 21 to 65 years of age. Adherence Guidelines recommend cytology tests (Pap smears) for individuals 21 to 29 years of age and cytology tests alone or with a high-risk human papillomavirus (hrHPV) test for individuals aged 30 to 65 years old. In 2023, 74.2% of US-eligible adults were determined to adhere to these guidelines. Research has indicated many influential social and cultural factors of CCS adherence, including religion. However, to our knowledge, no studies have been conducted in the US to assess the specific influences of Christian denominations on CCS adherence. Research indicates that discussions about sexual health may be stigmatized among Christian denominations in the US. Additionally, testing for HPV may be viewed as a rejection of abstinence, which is advocated by my many Christian denominations, further applying social stigmas to CCS screening. Therefore, this study explored associations between CCS guideline adherence and religious denomination affiliation, accounting for other demographic characteristics. Method: Women aged21-49 years old (n =4561) were examined for USPSTF CCS adherence from the National Survey of Family Growth (2017-2019). A weighted multivariable logistic regression was used to examine the likelihood of adhering to CCS guidelines by Christian denomination compared to no religious affiliation, controlling for race/ethnicity, education, and age group. Adherence was determined by the last reported Pap test and last reported HPV test, with up-to-date status varying across age groups in accordance with USPSTF guidelines (21-29 years old compared to 30+ years old). Women reporting a history of a hysterectomy were excluded from the analysis. Results: Overall, 56.3% of participants adhered to the CCS guidelines. The rates of adherence to CCS guidelines across the available Christian denominations were 65.8% among Black Protestants, 59.0%amongMainline Protestants, 53.2% among Catholics, 49.6% among Evangelical Protestants,49.3%for those of another Religion, and 58.7% for those with no religious affiliation. Evangelical Protestants and individuals self-identifying with non-Christian religions had lower odds of screening guidelines compared to those with no religious affiliation(OR = 0.80, 95%CI [0.66, 0.98]and OR=0.67,95%CI [0.52,0.86],respectively).Women who self-identified as non-Hispanic Black were more likely to adhere to CCS guidelines than non-Hispanic White women(OR= 1.96, CI [1.52, 2.53]).Women 30 years or older were less likely to adhere than 21–29-year-olds (OR = 0.19,CI [0.16,0.22]).Compared to individuals who obtained bachelor's degrees, there was no significant association with the odds of CCS adherence among other educational levels in the multivariable model. Conclusion: Associations were observed between adhering to CCS guidelines and religious denomination after accounting for race/ethnicity, age, and education. Women who were Evangelic Protestants or part of a non-Christian religion were less likely to adhere. Additional studies should further evaluate associations and advise culturally tailored campaigns to reduce CCS stigmas and increase overall adherence.en_US
dc.titleIs there a relationship between Religious Affiliation and Adherence to Recommended Cervical Cancer Screening Guidelines?en_US