Adherence to Cervical Cancer Screening Guidelines for U.S. Women Aged 25–64: Data from the 2005 Health Information National Trends Survey (HINTS)

Abstract

Background: Although it is widely accepted that Papanicolaou (Pap) screening can reduce cervical cancer mortality, many women still do not maintain regular cervical cancer screenings. Objective: To describe the prevalence of cervical cancer screening and the demographic, behavioral, psychological, and cancer-related knowledge factors associated with adherence to U.S. Preventive Services Task Force (USPSTF) cervical cancer screening guidelines among women in the United States. Methods: Data for women aged 25-64 were obtained from the National Cancer Institute's (NCI) 2005 Health Information National Trends Survey (HINTS). Women were considered adherent to screening guidelines if they had two consecutive, on-schedule screenings and planned to have another within the next 3 years. The sample comprised 2070 women. Results: Ninety-eight percent of women reported ever having a Pap smear, 90% reported having had a recent Pap smear (within 3 years), and 84% were adherent to USPSTF screening guidelines. Maintaining regular cervical cancer screening was significantly associated with having health insurance, normal body mass index (BMI), smoking status (nonsmoker), mood (absence of a mood disturbance), and being knowledgeable about cervical cancer screening and human papillomavirus (HPV) infection. Conclusions: Based on the observation that women who were current smokers, obese, or experiencing a substantial degree of psychological distress were significantly less likely to adhere to recommended screening guidelines, we suggest that healthcare providers pay particular attention to the screening needs of these more vulnerable women.

Identifying barriers to Papanicolaou smear screening in Korean women: Korean National Health and Nutrition Examination Survey 2005

“…There is evidence that smokers have greater depression, negative affectivity, anxiety sensitivity and hostility; a tendency toward sensation seeking and impulsivity; deficient coping skills; a present time perspective; and a tendency to rationalize risk. [25][26][27][28][29][30][31][32][33][34][35] In this study, compared with women who not had hormone replacement therapy, women currently under hormone therapy are significantly more likely to have regular Pap tests. In most cases, women start taking hormone replacement therapy around 50 after menopause.…”

Smoking as a major risk factor for cervical cancer and pre-cancer: Results from the EPIC cohort

“…Furthermore, EPIC did not collect information on screening attendance, and it has been reported that smoking is associated with less adherence to screening programs. 38 Thus, we cannot rule out that some residual confounding by screening may explain some of the associations with CIN3/CIS.…”

Adherencia al tamizaje de cáncer cérvicouterino: Una mirada desde el modelo de determinantes sociales de la salud

“…La presencia de seguro de salud es un factor que determina una mayor adherencia al tamizaje (6,8,11,13,19,22,31,32,(34)(35)(36). En el estudio de Cook y cols (31) dicha asociación varió según la edad, siendo mayor en mujeres menores de 45 años.…”

“…Un mayor número de visitas médicas (5,15), la presencia de un control médico en el último tiempo (10,12,21,35,38,39) y contar con prestador de salud habitual (33,40) son predictores de mayor adherencia. Específicamente, se ha descrito que visitar al mismo ginecólogo también se considera como un factor de adherencia importante; esto puede deberse al efecto que genera una mejor relación profesional y un mejor seguimiento de la mujer (10).…”

“…El conocimiento y las creencias que la mujer tiene acerca del PAP y del CC han sido motivo de múltiples investigaciones, reportándose que una mejor adherencia se produce en mujeres con mayor conocimiento (10,23,17,30,34,35,40,43), y con mejores (correctas) creencias (10,12,13,17,27,40,44). Dentro de las principales razones que impiden una mejor adherencia son el miedo o vergüenza de ir al médico (42).…”