title: Pap smear receipt among Vietnamese immigrants: the importance of health care factors.
abstract: OBJECTIVE
  Recent US data indicate that women of Vietnamese descent have higher cervical cancer incidence rates than women of any other race/ethnicity, and lower levels of Pap testing than white, black, and Latina women. Our objective was to provide information about Pap testing barriers and facilitators that could be used to develop cervical cancer control intervention programs for Vietnamese American women.
  
  
  METHODS
  We conducted a cross-sectional, community-based survey of Vietnamese immigrants. Our study was conducted in metropolitan Seattle, Washington, DC. A total of 1532 Vietnamese American women participated in the study. Demographic, health care, and knowledge/belief items associated with previous cervical cancer screening participation (ever screened and screened according to interval screening guidelines) were examined.
  
  
  RESULTS
  Eighty-one percentage of the respondents had been screened for cervical cancer in the previous three years. Recent Pap testing was strongly associated (p<0.001) with having a regular doctor, having a physical in the last year, previous physician recommendation for testing, and having asked a physician for testing. Women whose regular doctor was a Vietnamese man were no more likely to have received a recent Pap smear than those with no regular doctor.
  
  
  CONCLUSIONS
  Our findings indicate that cervical cancer screening disparities between Vietnamese and other racial/ethnic groups are decreasing. Efforts to further increase Pap smear receipt in Vietnamese American communities should enable women without a source of health care to find a regular provider. Additionally, intervention programs should improve patient-provider communication by encouraging health care providers (especially male Vietnamese physicians serving women living in ethnic enclaves) to recommend Pap testing, as well as by empowering Vietnamese women to specifically ask their physicians for Pap testing.
authors.affiliation: Fred Hutchinson Cancer Research Center, Division of Public Health Sciences, Washington, DC, USA. vtaylor@fhcrc.org
authors.forename: Victoria M
authors.initials: VM
authors.lastname: Taylor
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Yasui
authors.forename: Tung T
authors.initials: TT
authors.lastname: Nguyen
authors.forename: Erica
authors.initials: E
authors.lastname: Woodall
authors.forename: H Hoai
authors.initials: HH
authors.lastname: Do
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Acorda
authors.forename: Lin
authors.initials: L
authors.lastname: Li
authors.forename: John
authors.initials: J
authors.lastname: Choe
authors.forename: J Carey
authors.initials: JC
authors.lastname: Jackson
mesh_terms: D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D054242:Emigrants and Immigrants; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008875:Middle Aged; D065006:Papanicolaou Test; D010342:Patient Acceptance of Health Care; D012044:Regression Analysis; D002583:Uterine Cervical Neoplasms / Q000208:ethnology / Q000517:prevention & control; D014626:Vaginal Smears / Q000706:statistics & numerical data*; D014744:Vietnam / Q000208:ethnology; D014861:Washington; D055815:Young Adult