The association between affordable care act implementation and the prevalence of women having ever received a Pap smear
Background To assess if implementation of the 2010 Patient Protection and Affordable Care Act (ACA) was associated with changes in the prevalence of women having ever received a pap smear.Methods This study utilised the publicly available Centre for Disease Control National Survey of Family Growth (...
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| Format: | Article |
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Taylor & Francis Group
2024-12-01
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| Series: | Journal of Obstetrics and Gynaecology |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/01443615.2024.2393359 |
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| author | Eric M. Ganz Benjamin Brown Heather Smith Lawren Wellisch Megha Gupta Stephen M. Wagner |
| author_facet | Eric M. Ganz Benjamin Brown Heather Smith Lawren Wellisch Megha Gupta Stephen M. Wagner |
| author_sort | Eric M. Ganz |
| collection | DOAJ |
| description | Background To assess if implementation of the 2010 Patient Protection and Affordable Care Act (ACA) was associated with changes in the prevalence of women having ever received a pap smear.Methods This study utilised the publicly available Centre for Disease Control National Survey of Family Growth (NSFG) data set. This was a serial cross-sectional study. The comparison groups were defined as women who received cancer screening and prevention interventions prior to full implementation of the ACA (2011–2013) and post full implementation (2017–2019). The primary outcome was self-reporting receipt of a Papanicolaou (Pap) smear. Secondary outcomes included HPV vaccination and mammogram rates. Anonymized patient information was collected from the nationally representative dataset, and analyses were performed utilising STATA 18.Results The two study cohorts obtained from the NSFG included women who responded in 2011–2013 (n = 5601), deemed to be ‘Pre-ACA implementation’ (Pre ACA), and those who responded in 2017–2019 (n = 6141) ‘Post-ACA implementation’ (Post ACA). The proportion of women who were 21 years and older and ever had a Pap smear in the Pre ACA group (96.0%) was higher than that of the Post ACA group (94.1%) (OR 0.66 (0.49–0.91)). In contrast, HPV vaccination rates rose, and mammogram rates remained stable in the Post ACA period.Conclusion A decrease in proportion of women ever having had a Pap smear despite implementation of health policies to increase access to preventive measures suggests further interventions to improve access to cervical cancer screening are warranted. |
| format | Article |
| id | doaj-art-29d34a6d4a7d41ce8e16a245005b920f |
| institution | Kabale University |
| issn | 0144-3615 1364-6893 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Journal of Obstetrics and Gynaecology |
| spelling | doaj-art-29d34a6d4a7d41ce8e16a245005b920f2025-01-09T12:13:17ZengTaylor & Francis GroupJournal of Obstetrics and Gynaecology0144-36151364-68932024-12-0144110.1080/01443615.2024.2393359The association between affordable care act implementation and the prevalence of women having ever received a Pap smearEric M. Ganz0Benjamin Brown1Heather Smith2Lawren Wellisch3Megha Gupta4Stephen M. Wagner5Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA, USADepartment of Obstetrics and Gynecology, Warren Alpert Medical School, Brown University, Providence, RI, USADepartment of Obstetrics and Gynecology, Warren Alpert Medical School, Brown University, Providence, RI, USABrown University School of Public Health, Providence, RI, USADepartment of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA, USADepartment of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA, USABackground To assess if implementation of the 2010 Patient Protection and Affordable Care Act (ACA) was associated with changes in the prevalence of women having ever received a pap smear.Methods This study utilised the publicly available Centre for Disease Control National Survey of Family Growth (NSFG) data set. This was a serial cross-sectional study. The comparison groups were defined as women who received cancer screening and prevention interventions prior to full implementation of the ACA (2011–2013) and post full implementation (2017–2019). The primary outcome was self-reporting receipt of a Papanicolaou (Pap) smear. Secondary outcomes included HPV vaccination and mammogram rates. Anonymized patient information was collected from the nationally representative dataset, and analyses were performed utilising STATA 18.Results The two study cohorts obtained from the NSFG included women who responded in 2011–2013 (n = 5601), deemed to be ‘Pre-ACA implementation’ (Pre ACA), and those who responded in 2017–2019 (n = 6141) ‘Post-ACA implementation’ (Post ACA). The proportion of women who were 21 years and older and ever had a Pap smear in the Pre ACA group (96.0%) was higher than that of the Post ACA group (94.1%) (OR 0.66 (0.49–0.91)). In contrast, HPV vaccination rates rose, and mammogram rates remained stable in the Post ACA period.Conclusion A decrease in proportion of women ever having had a Pap smear despite implementation of health policies to increase access to preventive measures suggests further interventions to improve access to cervical cancer screening are warranted.https://www.tandfonline.com/doi/10.1080/01443615.2024.2393359Papanicolaouvaccinationscreeningmammographysurveys |
| spellingShingle | Eric M. Ganz Benjamin Brown Heather Smith Lawren Wellisch Megha Gupta Stephen M. Wagner The association between affordable care act implementation and the prevalence of women having ever received a Pap smear Journal of Obstetrics and Gynaecology Papanicolaou vaccination screening mammography surveys |
| title | The association between affordable care act implementation and the prevalence of women having ever received a Pap smear |
| title_full | The association between affordable care act implementation and the prevalence of women having ever received a Pap smear |
| title_fullStr | The association between affordable care act implementation and the prevalence of women having ever received a Pap smear |
| title_full_unstemmed | The association between affordable care act implementation and the prevalence of women having ever received a Pap smear |
| title_short | The association between affordable care act implementation and the prevalence of women having ever received a Pap smear |
| title_sort | association between affordable care act implementation and the prevalence of women having ever received a pap smear |
| topic | Papanicolaou vaccination screening mammography surveys |
| url | https://www.tandfonline.com/doi/10.1080/01443615.2024.2393359 |
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