title: Pap test results among low-income youth: prevalence of dysplasia and practice implications.
abstract: 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.
authors.affiliation: School of Nursing, University of Minnesota, Minneapolis 55454, USA. halco001@tc.umn.edu
authors.forename: Linda L
authors.initials: LL
authors.lastname: Halcón
authors.forename: Alan R
authors.initials: AR
authors.lastname: Lifson
authors.forename: Marcia
authors.initials: M
authors.lastname: Shew
authors.forename: Marilyn
authors.initials: M
authors.lastname: Joseph
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Hannan
authors.forename: Charles R
authors.initials: CR
authors.lastname: Hayman
mesh_terms: 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*