title: Facilitators and barriers to cervical cancer screening among Chinese Canadian women.
abstract: BACKGROUND
  Chinese Canadian women have higher cervical cancer incidence, and lower Pap testing, rates than the general Canadian population. Predisposing, enabling and reinforcing factors associated with ever having a Pap test, and having a recent Pap test within the last 2 years, were assessed in Chinese women in British Columbia using the PRECEDE-PROCEED model.
  
  
  METHODS
  Chinese women (n=512) between the ages of 20 and 79 years and residing in Greater Vancouver were interviewed about Pap testing, health care, traditional health beliefs, acculturation and sociodemographic characteristics. Two analyses were done, comparing women who had ever and never had a Pap test, and comparing women who had and had not received a recent Pap test. Focus groups and qualitative interviews ensured cultural sensitivity in the survey questionnaire.
  
  
  RESULTS
  Seventy-six percent reported ever having a Pap test and 57% reported having a Pap test within the last 2 years. Traditional health beliefs were not associated with ever or recent Pap testing. However, belief that Pap testing prevented cancer and general knowledge about the Pap test were associated with screening. Concern about pain/discomfort with the test, availability of time, culturally sensitive health care services and recommendation for Pap testing by a physician were also associated with screening. Factors differed for ever, and recently, having a Pap test.
  
  
  CONCLUSIONS
  Pap testing is less common among Chinese Canadian women. Continuing education about Pap testing is recommended for physicians serving underscreened Chinese women. Culturally and linguistically appropriate educational materials are needed for the Chinese community.
authors.affiliation: Population and Preventive Oncology, BC Cancer Agency, Vancouver, BC. ghislop@bccancer.bc.ca
authors.forename: T G
authors.initials: TG
authors.lastname: Hislop
authors.forename: M
authors.initials: M
authors.lastname: Deschamps
authors.forename: C
authors.initials: C
authors.lastname: Teh
authors.forename: C
authors.initials: C
authors.lastname: Jackson
authors.forename: S P
authors.initials: SP
authors.lastname: Tu
authors.forename: Y
authors.initials: Y
authors.lastname: Yasui
authors.forename: S M
authors.initials: SM
authors.lastname: Schwartz
authors.forename: A
authors.initials: A
authors.lastname: Kuniyuki
authors.forename: V
authors.initials: V
authors.lastname: Taylor
mesh_terms: D000328:Adult; D000368:Aged; D001955:British Columbia; D002681:China / Q000208:ethnology; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008403:Mass Screening / Q000706:statistics & numerical data*; D008875:Middle Aged; D010342:Patient Acceptance of Health Care / Q000208:ethnology*; D012044:Regression Analysis; D011795:Surveys and Questionnaires; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000208:ethnology; D014626:Vaginal Smears / Q000706:statistics & numerical data*