title: Do cervical cancer screening rates increase in association with an intervention designed to increase mammography usage?
abstract: OBJECTIVE
  To assess cervical cancer screening behaviors among underserved women participating in an intervention designed to increase mammography use.
  
  
  METHODS
  This was a randomized trial of 897 women from three racial groups (white, African American, Native American) living in a rural county in North Carolina. Baseline and followup surveys were completed by 815 women; 775 women provided data to be included in these analyses. The intervention group received an educational program focused on mammography delivered by a lay health advisor, and the control group received a physician letter/brochure focusing on Pap tests.
  
  
  RESULTS
  Women in both the intervention (OR 1.70; 1.31, 2.21, p < 0.001) and control groups (OR 1.38; 1.04, 1.82, p = 0.025) significantly increased cervical cancer screening rates within risk appropriate guidelines. No differences by racial group were documented. Women categorized in the high-risk group for developing cervical cancer (>2 sexual partners, age <18 years at first sexual intercourse, smoker; treated for sexually transmitted disease [STD] or partner with treated STD) significantly (OR 1.88; 1.54, 2.28, p < 0.001) increased Pap test completion. However, a nonsignificant increase (OR 1.25; 0.87, 1.79, p = 0.221) in Pap test completion was demonstrated in women categorized as low risk for cervical cancer.
  
  
  CONCLUSIONS
  This study suggests that women in an intensive behavioral intervention designed to increase mammography use may also increase Pap test completion, similar to a minimal intervention focused only on increasing Pap test completion. These results have implications for the design and evaluation of behavioral intervention studies.
authors.affiliation: The School of Public Health, The Ohio State University Comprehensive Cancer Center, Columbus, Ohio 43210, USA. mira.katz@osumc.edu
authors.forename: Mira L
authors.initials: ML
authors.lastname: Katz
authors.forename: Cathy M
authors.initials: CM
authors.lastname: Tatum
authors.forename: Cecilia R
authors.initials: CR
authors.lastname: Degraffinreid
authors.forename: Stephanie
authors.initials: S
authors.lastname: Dickinson
authors.forename: Electra D
authors.initials: ED
authors.lastname: Paskett
mesh_terms: D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000517:prevention & control; D016001:Confidence Intervals; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008327:Mammography / Q000706:statistics & numerical data*; D008403:Mass Screening / Q000706:statistics & numerical data*; D008875:Middle Aged; D009657:North Carolina / Q000453:epidemiology; D016017:Odds Ratio; D010342:Patient Acceptance of Health Care / Q000523:psychology* / Q000706:statistics & numerical data; D018570:Risk Assessment / Q000379:methods; D011795:Surveys and Questionnaires; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000517:prevention & control; D016387:Women's Health; D014932:Women's Health Services / Q000458:organization & administration