Cervical Cancer Risk and Screening Behaviors in Women Veterans with PTSD

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Investigator: George F. Sawaya, MD
Sponsor: Veterans Affairs, Dept of

Location(s): United States

Description

Cervical cancer is an important yet under-discussed sexual health outcome, both because its most common cause is actually the sexually transmitted infection HPV and because it can be detected through routine gynecologic examinations. However, there has been little published research examining the rates of screening for cervical cancer among individuals with PTSD, although there are a number of reasons to suspect that such individuals would be underscreened. Particularly, depression, which commonly occurs alongside PTSD, has been associated with reduced screening, while PTSD is associated with poor medical adherence, which may very well include cervical cancer examinations. As well, psychiatric illness in general tends to be associated with lower socioeconomic status and limited access to health care, both of which can impact the development of cervical cancer. As over one-fourth of female veterans experience PTSD—more than double the civilian rate—understanding the connection between this condition and such a key preventive health service as screening for cervical cancer is important to promoting the reproductive, sexual, and general health of women in our military services.

This study is evaluating receipt of cervical cancer screening in a medical record review of anational sample of 34,213 women veterans using Veteran Health Administration facilities between 2003 and 2007 and diagnosed with 1) posttraumatic stress disorder (PTSD), or 2) depression, or 3) no psychiatric illness. The study features a cross-sectional design in which logistic regression analyses compared receipt of recommended cervical cancer screening for all three diagnostic groups.