title: Predictors of patient comfort and adherence with less frequent cervical cancer screening.
abstract: BACKGROUND
  The Papanicolaou (Pap) test is an effective, well-accepted screening tool that has led to a decrease in cervical cancer incidence and mortality. Updated evidence-based cervical cancer screening guidelines support less frequent testing in low-risk patients but have  met resistance from providers and patients.
  
  
  OBJECTIVE
  To assess patient knowledge about cervical cancer screening and attitudes toward recommendations for less frequent testing.
  
  
  METHODS
  A hard copy of an eight-question survey was distributed to 389 women aged 30-64  years at two primary care clinics in Rochester, Minnesota, over a six-week period.
  
  
  RESULTS
  The survey response rate was 86.8%. Of the 280 women who responded to a survey question about the cause of cervical cancer, 212 (75.7%) identified human papillomavirus (HPV) as the cause.  Multivariable logistic regression analysis showed that this knowledge was not associated with feeling comfortable with a recommendation for less frequent testing or with support for less frequent testing. The only significant predictor of patient comfort and adherence with a two- to three-year  Pap testing interval was the patient's belief about whether a Pap test was needed annually or every two or three years.
  
  
  CONCLUSIONS
  Patient belief about Pap testing frequency was the strongest predictor of attitude toward less frequent Pap testing and was not based on knowledge  of HPV. Future studies should explore why some patients continue to expect annual testing and identify interventions to help providers elicit and change patients' expectations about cervical cancer screening.
authors.affiliation: Department of Family Medicine, Mayo Clinic, Rochester, MN 55905, USA. maclaughin.kathy@mayo.edu
authors.forename: Kathy L
authors.initials: KL
authors.lastname: MacLaughlin
authors.forename: Kurt B
authors.initials: KB
authors.lastname: Angstman
authors.forename: Priscilla M
authors.initials: PM
authors.lastname: Flynn
authors.forename: Jessica R
authors.initials: JR
authors.lastname: Schmitt
authors.forename: Amy L
authors.initials: AL
authors.lastname: Weaver
authors.forename: Lynne T
authors.initials: LT
authors.lastname: Shuster
mesh_terms: D000328:Adult; D055088:Early Detection of Cancer / Q000379:methods*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008875:Middle Aged; D065006:Papanicolaou Test; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis*; D014626:Vaginal Smears / Q000379:methods*