Approximately 1,450 new cases and 430 deaths from cervical cancer were estimated to occur among Canadian women during 2000, resulting in an estimated incidence rate of 8.4 per 100,000 women. 1 Observed declines in cervical cancer incidence and mortality rates in previous years are largely attributed to the widespread adoption of Pap screening. 1 Current Canadian guidelines recommend women receive annual Pap tests once sexually active or at age 18 with a reduction in screening frequency to every three years after two normal smears to the age of 69, in the presence of an organized screening program. 2,3 Currently, there are no comprehensive screening programs in Canada, although several provinces have programs with several of the required elements. [4][5][6] Although cervical cancer is almost completely preventable through regular screening, Pap tests remain underused by some women. Studies consistently show that among new cases, a relatively high proportion of women report no or poor participation in a Pap screening program. 7,8 As the early stages of cervical cancer (non-invasive) are asymptomatic, routine screening can result in better prognosis for the patient. 9,10 If cervical cancer is detected when symp-toms are apparent, the five-year survival rate is only 10%, but with early detection exceeds 90%. 2 Research has illustrated the relative importance of several sociodemographic, health and lifestyle factors to Pap screening among North American women. [11][12][13][14][15][16] Significant predictors of under-utilization include older age, lower education, non-English language, ethnic background, single marital status and poor preventive health behaviours.This study examines the consistency of findings regarding sociodemographic, health and lifestyle factors that promote appropriate cervical cancer screening among different age groups of Canadian women in the 1996-97 National Population Health Survey (NPHS). Questions regarding reasons for not obtaining a Pap test were added to this survey cycle; thus, a secondary objective was to examine the relative importance of personal and system barriers to Pap test participation among this sample.
METHODSThe NPHS is an ongoing survey conducted by Statistics Canada involving the collection of cross-sectional and longitudinal data on the health of Canadians. Data from the second cycle (1996-97) of the household component, obtained primarily through telephone interviews, were used to examine the relation of sociodemographic, health and lifestyle factors to Pap test participation in a representative sample of the non-institutionalized population.Of the 36,667 female respondents aged 18+ years, 34,832 consented to share their
