title: Pap smear use in a population of older Mexican-American women.
abstract: BACKGROUND
  Hispanic women and older women (age > or = 50 years) in general have been identified as populations of women who often underutilize Papanicolaou (Pap) smears.
  
  
  OBJECTIVE
  To report the rates of cervical cancer screening in a group of older Mexican American women and to identify the correlates of having a Pap smear in the past three years.
  
  
  METHODS
  The Mammography Use by Older Mexican-American Women Survey, a stratified area probability sample of 452 women ages 50-74 from three southeast Texas counties. Self-report data was collected with in-person interviews from 1997 to 1999.
  
  
  RESULTS
  We found that 93.1% of the women reported at least one Pap smear in their lifetime and that 64.1% reported a Pap smear in the past three years. Odds of reporting a recent Pap smear was lower for older women (OR 0.51, 95% CI 0.32-0.82) and those below the poverty line (OR 0.52, 95% CI 0.33-0.82). The odds were higher for women who had a regular doctor for female care (OR 6.49, 95% CI 2.96-14.23) or a regular clinic or hospital source for female care (OR 5.50, 95% CI 2.55-11.89). Among these older Mexican-American women, cultural factors (language of interview, acculturation, fatalism) did not have a significant effect on screening use.
  
  
  CONCLUSIONS
  Recent Pap smear use (64.1%) falls well below the year 2010 goal of 90%. Efforts need to be made to overcome barriers to Pap smear utilization for these women, such as providing access to female medical care.
authors.affiliation: Department of Preventive Medicine and Community Health, University of Texas Medical Branch, Galveston 77555-1153, USA.
authors.forename: Whitney M
authors.initials: WM
authors.lastname: Randolph
authors.forename: Daniel H
authors.initials: DH
authors.lastname: Freeman
authors.forename: Jean L
authors.initials: JL
authors.lastname: Freeman
mesh_terms: D000367:Age Factors; D000368:Aged; D005260:Female; D019538:Health Care Surveys; D006297:Health Services Accessibility; D006801:Humans; D008327:Mammography / Q000706:statistics & numerical data*; D008403:Mass Screening / Q000706:statistics & numerical data*; D017058:Mexican Americans / Q000523:psychology* / Q000706:statistics & numerical data; D008875:Middle Aged; D016017:Odds Ratio; D065006:Papanicolaou Test; D010342:Patient Acceptance of Health Care / Q000208:ethnology* / Q000706:statistics & numerical data; D012650:Self Disclosure; D013781:Texas; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis*; D014626:Vaginal Smears / Q000706:statistics & numerical data*