title: Factors associated with cervical cancer screening in Puerto Rico.
abstract: BACKGROUND
  Racial/ethnic disparities in cervical cancer screening exist in the United States; rates are lowest among women who live in Puerto Rico. We identified factors associated with cervical cancer screening among women aged 18 years or older living in Puerto Rico.
  
  
  METHODS
  We included women who participated in the Puerto Rico Behavioral Risk Factor Surveillance System in 2006 who had not had a hysterectomy (n = 2,206). We calculated the weighted population prevalence estimates of Papanicolaou (Pap) test screening in the past 3 years and used logistic regression models to assess factors associated with screening.
  
  
  RESULTS
  Most participants (71.9% [95% confidence interval (CI) = 69.4%-74.4%]) reported having had a Pap test in the preceding 3 years. Factors associated with screening in multivariate analysis included routine checkup in the past year and leisure-time physical activity. Compared with women with a household income less than $15,000, those with higher incomes were more likely to have had a Pap test. Similarly, divorced or separated women were more likely to have been screened (odds ratio [OR] = 1.13; 95% CI = 1.12-1.15) than those who were married/living together. We did not find associations between screening behavior and education, health care coverage, body mass index, or smoking status.
  
  
  CONCLUSIONS
  The prevalence of cervical cancer screening in Puerto Rico is below the 90% recommendation established by Healthy People 2010. Our findings regarding factors associated with Pap screening behavior identified population subgroups who are underscreened and who may benefit from targeted interventions and screening programs.
authors.affiliation: University of Puerto Rico Comprehensive Cancer Center and University of Puerto Rico Medical Sciences Campus, PMB 711, 89 De Diego Ave, Ste 105, San Juan, Puerto Rico 00927-6346. ana.ortiz7@upr.edu
authors.forename: Ana P
authors.initials: AP
authors.lastname: Ortiz
authors.forename: Sarah
authors.initials: S
authors.lastname: Hebl
authors.forename: Ruby
authors.initials: R
authors.lastname: Serrano
authors.forename: María E
authors.initials: ME
authors.lastname: Fernandez
authors.forename: Erick
authors.initials: E
authors.lastname: Suárez
authors.forename: Guillermo
authors.initials: G
authors.lastname: Tortolero-Luna
mesh_terms: D000293:Adolescent; D000328:Adult; D055088:Early Detection of Cancer / Q000379:methods*; D005006:Ethnicity; D005260:Female; D006801:Humans; D008875:Middle Aged; D065006:Papanicolaou Test; D015995:Prevalence; D011647:Puerto Rico / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000208:ethnology; D014626:Vaginal Smears; D055815:Young Adult
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