Numeracy and cervical cancer screening

Background: Although it is well documented that regular Pap tests improve cervical cancer mortality, many women do not adhere to screening guidelines. Low health literacy may be a factor that contributes to underutilization of cancer screening. Numeracy is one aspect of health literacy that may be particularly important for cancer screening. The objective of the current study is to examine the relationship between numeracy and Pap test utilization. Methods: The 2007 Health Information National Trends Survey (HINTS) was used for this analysis. Chi-square tests examined the association between demographic variables and having a Pap test within the last 3 years. Multivariate logistic regression models were run to examine the association between numeracy skills and Pap test utilization Results: Race/ethnicity, age, education, health insurance status, and income differed among those who received a Pap test within the last 3 years and women who did not receive a Pap test within the last 3 years. Both lower perceived and demonstrated numeracy skills were associated with decreased odds of receiving a Pap test within the last 3 years. Conclusions: Regular cervical cancer screening reduces cervical cancer mortality, and numbers are often used to communicate this message. If people are unable to understand and correctly interpret numerical risk messages, these messages are ineffective. Future research should examine factors that may mediate the relationship between numeracy and cervical cancer screening, the disconnect between perceived and demonstrated numeracy skills particularly among African-Americans, and non-numerical ways of communicating risk.