title: Factors associated with Pap smear screening among French women visiting a general practitioner in the Rhône-Alpes region.
abstract: BACKGROUND
  To help prevent cervical cancer, three yearly opportunistic Pap smear screening is recommended in France for women aged 25-65 years. Pap smear screening coverage varies with age and socioeconomic level. The aim of this cross-sectional study was to identify factors associated with a low uptake of Pap smear screening among women with no limited access to healthcare.
  
  
  METHODS
  We analyzed data from women aged 25-65 living in the Rhône-Alpes region who completed a self-administered questionnaire given to them by general practitioners between June and August 2008. The questionnaire covered knowledge about cervical cancer and its prevention as well as the women's history of Pap smear screening and other health-related behaviors. The relationship between low uptake of Pap smear screening--defined as not having had the test within the past 3 years--and a range of possible contributing factors was investigated using logistic regression.
  
  
  RESULTS
  Of 1186 women with an intact uterus who completed the questionnaire, 89.1% said they had had a Pap smear within the past 3 years. On multivariate analysis, the 10.9% who had not were significantly more likely to live alone (1.76 [1.13-2.74]), to have no children (2.17 [1.31-3.62]), to have never used contraception (5.35 [2.98-9.62]), to have less knowledge about Pap smear screening (3.40 [1.55-7.49]), and to be unvaccinated against hepatitis B (0.55 [0.35-0.87]).
  
  
  CONCLUSIONS
  Despite high overall compliance with Pap smear screening recommendations among women who consulted general practitioners, several factors were significantly associated with a low uptake of the service. Considering these factors may help to refine messages aimed at cervical cancer prevention.
authors.affiliation: Département de santé publique, centre Léon-Bérard, 69373 Lyon cedex 08, France.
authors.forename: N
authors.initials: N
authors.lastname: Oussaid
authors.forename: D
authors.initials: D
authors.lastname: Lutringer-Magnin
authors.forename: G
authors.initials: G
authors.lastname: Barone
authors.forename: J
authors.initials: J
authors.lastname: Haesebaert
authors.forename: C
authors.initials: C
authors.lastname: Lasset
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D005602:France / Q000453:epidemiology; D058005:General Practitioners / Q000706:statistics & numerical data*; D006801:Humans; D008403:Mass Screening / Q000706:statistics & numerical data*; D008875:Middle Aged; D010349:Patient Compliance / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis*; D014626:Vaginal Smears / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: Adhésion; Cancer du col de l’utérus; Cervical cancer; Compliance; Facteurs; Factors; France; Frottis cervico-utérin; Pap smear screening; Prevention; Prévention