Prevalence and risk factors for lifetime exposure to Pap smear abnormalities in the Australian community.
BACKGROUND
This study examined the prevalence, correlates and consequences of abnormal Pap smears in a population-based survey of sexuality and health in the Australian community.


METHODS
Cross-sectional telephone survey of 908 women aged 18-59 years randomly selected from the Commonwealth electoral roll.


RESULTS
Most women (91%) reported having had at least one Pap smear test, a figure directly comparable with national estimates. Being single (prevalence ratio (PR) 4.61; 95% CI 2.09-10.17) and not having had sexual intercourse (PR 5.31, 95% CI 3.11-9.07) were strong predictors of never having been tested. One in four women (26%) who reported being screened also reported having had an abnormal Pap smear result, of whom 66% said they had further testing and 52% some form of treatment. A minority (19%) reported negative effects of treatment on their sex lives. Having been diagnosed with human papillomavirus (HPV) (PR 2.87, 95% CI 1.84-4.48), and to a lesser degree, having had a greater number of male sexual partners (PR 1.38, 95% CI 1.01-1.89), and experiencing sexual problems in the last year (PR 0.99, 95% CI 0.99-1.88) were independently associated with reporting of abnormal Pap smear results.


CONCLUSIONS
Approximately one in four women self report lifetime exposure to Pap smear abnormalities. It is important that women are well prepared for this common experience. A causal association between multiple sexual partners and risk of acquiring HPV infection is supported by these data.
Posner
T Natasha
TN
Department of Primary Care and General Practice, Clinical Sciences Building, University of Birmingham, Edgbaston B15 2TT, UK. posnertr@adf.bham.ac.uk
Boyle
Frances M
FM
Purdie
David M
DM
Dunne
Michael P
MP
Najman
Jake M
JM
D000293:Adolescent; D000328:Adult; D001315:Australia / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D005831:Genital Diseases, Female / Q000175:diagnosis / Q000453:epidemiology*; D006801:Humans; D008875:Middle Aged; D065006:Papanicolaou Test; D015995:Prevalence; D016016:Proportional Hazards Models; D012307:Risk Factors; D011795:Surveys and Questionnaires; D014626:Vaginal Smears