This study examined Pap smear coverage among low-income Brazilian women living in Salvador, Brazil to identify factors associated with the lack of screening. The fieldwork occurred during September 1996 through March 1997.
The participants consisted of 275 women 20 through 49 years of age who agreed to a face-to-face interview. Univariate associations between the outcome variable of non-screened women, defined as not having a Pap smear in greater than three years or never in a lifetime, and independent variables were assessed to identify subgroups of women at risk for not getting screened. The joint association of several predictor variables and non-screening status was examined by logistic regression.
A profile of non-screeners which was 22% of the sampled women showed that they were older (OR=6.2; 95% CI:2.2,18), had less than minimum wage (OR=6.9; 95% CI:1.6,20) and avoided going to the doctor (OR=5.5; 95% CI:2.0,16). The main predictors of non-screening in the logistic regression were never attended school (OR=6.3; 95% CI:1.4,29), lack of knowledge about cervical cancer issues (OR=4.2; 95% CI:1.8,9.8) and no reported gynecology visit (OR=32; 95% CI:12,83).
These findings confirm the importance of understanding the factors associated with non-compliance with Pap smear screening in order to develop cancer prevention policies and services. The absence of gynecology visit was the strongest predictor of non-screening in the logistic analysis exemplifying the importance and limitation of this service. These results affirm that there are subgroups of women that are still at risk of not receiving adequate preventive exams.
Learning Objectives: Learning objectives: At the conclusion of the presentation the audience will be able to: 1) list barriers to Pap smear screening, 2) discuss reasons subgroups of women remain at risk, and 3) identify strategies to decrease risk.
Keywords: Cancer Screening, Behavioral Research
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.