Cancer screening practices among women in a community health center population.
BACKGROUND
Cancer takes a disproportionate toll on disadvantaged Americans. Poverty and low education are risk factors for underuse of cancer screening.


METHODS
In this report, we discuss predictors of adherence to cancer screening (mammography, clinical breast exam [CBE], and Pap tests) among 926 women who receive care at a community health center that serves a predominantly low-income and minority population. We examine predictors for each of the tests and for a composite measure of overall cancer screening test compliance. In studying multiple screening behaviors we not only investigate factors associated with each individual behavior, but we also identify consistently effective factors across several behaviors.


RESULTS
The analysis indicates consistent effects of age, education, and insurance status on cancer screening. In addition, decisional balance, a measure of a person's beliefs about the pros and cons of complying with the screening test, is associated strongly with adherence. We have extended earlier findings about the positive relationship between decisional balance and mammography to include decisional balance and Pap tests, as well. This finding suggests that behavioral interventions that target decisional balance can effectively promote adherence to cancer screening tests.
Rimer
B K
BK
Duke Comprehensive Cancer Center, Duke University Medical Center, Durham, North Carolina, USA.
Conaway
M R
MR
Lyna
P R
PR
Rakowski
W
W
Woods-Powell
C T
CT
Tessaro
I
I
Yarnall
K S
KS
Barber
L T
LT
D000293:Adolescent; D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000517:prevention & control*; D003151:Community Health Centers; D003710:Demography; D005260:Female; D015438:Health Behavior; D006801:Humans; D008327:Mammography / Q000706:statistics & numerical data*; D008875:Middle Aged; D010349:Patient Compliance; D011237:Predictive Value of Tests; D012494:Sampling Studies; D012959:Socioeconomic Factors; D002583:Uterine Cervical Neoplasms / Q000517:prevention & control*; D014626:Vaginal Smears / Q000706:statistics & numerical data*