Race-specific results of Papanicolaou testing and the rate of cervical neoplasia in the National Breast and Cervical Cancer Early Detection Program, 1991-1998 (United States)

Objective: To describe differences in cervical screening and biopsy results by race or ethnicity from women in the National Breast and Cervical Cancer Early Detection Program (NBCCEDP). Methods: We examined the percentage of abnormalities detected by Papanicola ou (Pap) tests and the rate of biopsy-diagnosed high-grade precancerous or cancerous lesions by racial or ethnic group. Results: Almost half the 628,085 women screened were members of racial or e thnic minority groups. American Indian or Alaska Native women were more lik ely than others to report never having had a prior Pap test. American India n or Alaska Native women had the highest proportion of abnormal Pap tests f or first program screens (4.4%), followed by blacks (3.2%), whites (3.0%), Hispanics (2.7%), and Asians or Pacific Islanders (1.9%). Whites had the hi ghest biopsy detection rate of high-grade lesions for first program screens (9.9 per 1000 Pap tests), followed by Hispanics (7.6), blacks (7.1), Ameri can Indians or Alaska Natives (6.7), and Asians or Pacific Islanders (5.4). Conclusions: This program provides important data on the prevalence of cerv ical neoplasia among diverse populations. Our findings that black women wit h a high-grade Pap test were less likely to get a work-up are disconcerting and merit further study and ultimate correction.