Non-utilization of the Pap Test Among Women with Frequent Health System Contact

Abstract

Despite improvements in health access, many underserved women abstain from cervical cancer screening. A self-administered questionnaire was used to identify factors determining whether medically underserved women attending a safety net health system regularly are screened for cervical cancer. Approximately 11 % of study subjects had never received a Pap test despite an average of nearly four clinic visits in the preceding 12 months. Never screeners were significantly younger, more likely to be Hispanic, non-U.S. born and less likely to have healthcare continuity. In multivariable analysis, odds for never screening were independently lower among women with male partner support (aOR 0.29) and physician's recommendation for screening (aOR 0.34) and higher among women who believed screening visits are too long (aOR 2.53). Educating male partners of Hispanic and immigrant women in addition to addressing recognized situational barriers may help to improve cervical cancer screening rates.

Attendance to cervical cancer screening among Roma and non-Roma women living in North-Western region of Romania

“…This finding is similar to a study reporting on associations between male partners wanting women to receive regular screening and women's likeliness to participate (Ogunwale et al 2016). Women who needed someone else´s permission to attend screening were less likely to attend screening than women who did not.…”

“…This has also been reported elsewhere (e.g. Byrd et al 2007;Mutyaba et al 2007;Ogunwale et al 2016). That 28 % of Roma women and 8% of non-Roma women needed permission to attend screening ( Supplementary Table 1) suggests that an information strategy that includes men could potentially be useful.…”

“…The link between number of sex partners and screening may also be understood in conjunction with other sexually transmitted infections, as a higher number of sex partners increases the risks of developing symptoms, which again may lead women to seek medical help and thereby attend screening. Several studies (Lim and Sasieni 2015;Mutyaba et al 2007;Ogunwale et al 2016) have shown that women who seek health care for purposes other than screening are more likely to take a screening-test. This is because as soon as contact between health care and women is established, screening becomes more available and thereby more achievable.…”

Qualitative assessment of knowledge and attitudes towards cervical cancer screening among male Latino immigrants in Houston, Texas

“…Within the U.S., Hispanic women are less likely to receive Pap smears than other ethnic groups, even after controlling for barriers to care [11]. Furthermore, several recent studies have found that a significant proportion of the women non-compliant with screening report that they have never been screened despite regular visits to their primary care provider for other clinical indications [12][13][14]. Thus, efforts to address barriers to cervical cancer screening, particularly among high risk populations, will remain important for the foreseeable future.…”

Pap Utilization Survey in Nueva Vida, Nicaragua: Professional and Health Promotoras Partnership

“…By using an effective screening service in the last 4 decades-a consequence of the introduction of the Pap test in 1941-the United States has reduced its incidence of cervical cancer by 70%. However, women who have never been screened with a Pap smear account for 29-50% of all cervical cancer diagnoses despite access to healthcare in developed countries (Ogunwale et al, 2016).…”