Abstract
In the United States, women who are categorized as Hispanic for public health research purposes, experience an increased risk of developing and dying from cervical cancer. This disparity primarily reflects underutilization of Pap smear screening, the best method available for prevention and early detection of disease. Previous research has not examined, in great detail, the factors that predict screening underutilization among Hispanic women or evaluated how known determinants of screening, such as cancer literacy, function across this population sub-group. Historically, all Hispanic persons, regardless of ancestry or country of origin, have been categorized as one group for cancer research and control efforts. This practice likely masks variability in exposure to determinants of disease, as well as, risk of cancer incidence and mortality. Our research examines potential differences in HPV knowledge between Hispanic women of diverse ancestral backgrounds. HPV is the primary risk factor for cervical carcinogenesis. Insufficient knowledge about this sexually transmitted infection (STI) and its association with cervical cancer may impact willingness to be vaccinated against HPV, screening utilization, and accordingly, women9s risk of disease onset and progression. Identifying variation in HPV knowledge between women of seemingly the same ethnicity, but different ancestral backgrounds, is essential for understanding, and ultimately attenuating, cervical cancer disparities. Study data were collected as part of a cross-sectional study conducted at the National Cancer Institute (NCI), Cancer Information Service (CIS), Spanish Call Center. Between July 2007 and March 2008, all callers to this service were asked whether they were willing to answer a short survey related to their knowledge of cervical cancer and associated risk factors. Where possible, survey items were derived from previously validated instruments and questionnaires. The HPV knowledge questions, in particular, were taken from the Health Information National Trends Survey (HINTS), conducted by the National Cancer Institute (NCI) on a biennial basis, with the intent of better understanding cancer information needs and experiences in the United States. Study data suggest that knowledge of HPV was high among our respondents (n=873; 69%), relative to a representative sample of US women of diverse/racial ethnic backgrounds. However, this knowledge varied by country of origin, even after controlling for acculturation, language preference, and number of years in the United States. Women from Mexico were far more likely than their South American and Caribbean counterparts to have heard of the virus. Such findings suggest that continuing to classify persons of similar ethnicity, but different cultural backgrounds and lifetime exposures as one group for research purposes, may preclude opportunity to understand, as well as attenuate, health disparity.