Pap test results among low-income youth: prevalence of dysplasia and practice implications.
OBJECTIVE
To describe Papanicolaou (Pap) test findings and identify prevalence and correlates of dysplastic cervical abnormalities in low-income adolescent females.


METHODS
This cross-sectional study included a modified random sample of female students ages 16 to 25 years at 54 U.S. Job Corps centers.


METHODS
5,734 female students enrolled in a federal job training program. Admission health records were reviewed and abstracted.


METHODS
Pap test findings using the Bethesda classifications. Pap smear results indicating dysplasia (atypical squamous cells of undetermined significance [ASCUS] with dysplasia) or squamous intraepithelial lesions (low-grade squamous interepithelial lesions [LGSIL] or high-grade squamous intraepithelial lesions [HGSIL]). Participants with less severe findings were compared with those who needed follow-up.


RESULTS
For 71.4% of participants, no abnormalities were found. 15.6% had benign cellular changes, 9.2% had reactive changes, and 9.9% had epithelial cell abnormalities. Of those tested, 5.6% (+/- 0.8%) had dysplastic Pap smear findings, with 0.3% (n = 12) HGSIL. All groups were equally affected, with abnormalities not associated with race/ethnicity, age, geographic region, education level, size of city of residence, or receiving public assistance.


CONCLUSIONS
In this population, dysplastic Pap smear results were not uncommon. Findings indicate that Pap screening, alone or in combination with more sensitive tests, can identify cervical abnormalities, including HGSIL, that suggest a need for further evaluation or follow-up.
Halcón
Linda L
LL
School of Nursing, University of Minnesota, Minneapolis 55454, USA. halco001@tc.umn.edu
Lifson
Alan R
AR
Shew
Marcia
M
Joseph
Marilyn
M
Hannan
Peter J
PJ
Hayman
Charles R
CR
D000293:Adolescent; D000294:Adolescent Behavior; D000328:Adult; D001294:Attitude to Health; D015331:Cohort Studies; D016001:Confidence Intervals; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D065006:Papanicolaou Test; D030361:Papillomavirus Infections / Q000175:diagnosis* / Q000453:epidemiology* / Q000451:nursing; D011203:Poverty; D015995:Prevalence; D011336:Probability; D018570:Risk Assessment; D014481:United States / Q000453:epidemiology; D002578:Uterine Cervical Dysplasia / Q000175:diagnosis* / Q000453:epidemiology* / Q000451:nursing; D014626:Vaginal Smears / Q000706:statistics & numerical data*