The association of social support and education with breast and cervical cancer screening.
BACKGROUND
Disparities in breast and cervical cancer screening by socioeconomic status persist in the United States. It has been suggested that social support may facilitate screening, especially among women of low socioeconomic status. However, at present, it is unclear whether social support enables mammogram and Pap test compliance.


OBJECTIVE
This study examines the association between social support and compliance with mammogram and Pap test screening guidelines, and whether social support provides added value for women of low education.


METHODS
Data were from a countywide 2009-2010 population-based survey, which included records of 2,588 women 40 years and older (mammogram) and 2,123 women 21 to 65 years old (Pap test). Compliance was determined using the guidelines in effect at the time of data collection.


RESULTS
Social support was significantly related to mammogram (adjusted odds ratio = 1.43; 95% confidence interval [1.16, 1.77]) and Pap test (adjusted odds ratio = 1.71; 95% confidence interval [1.27, 2.29]) compliance after controlling for age, race, having a regular health care provider, and insurance status. The interaction between social support and education had a significant effect on Pap test compliance only among women younger than 40; the effect was not significant for mammogram compliance.


CONCLUSIONS
Social support is associated with breast and cervical cancer screening compliance. The association between education and cancer screening behavior may be moderated by social support; however, results hold only for Pap tests among younger women. Practitioners and researchers should focus on interventions that activate social support networks as they may help increase both breast and cervical cancer screening compliance among women with low educational attainment.
University of Pittsburgh, Pittsburgh, PA, USA documetp@yahoo.com.
Patricia
P
Documet
University of Pittsburgh, Pittsburgh, PA, USA.
Todd M
TM
Bear
University of Pittsburgh, Pittsburgh, PA, USA.
Jason D
JD
Flatt
University of Pittsburgh, Pittsburgh, PA, USA.
Laura
L
Macia
University of Pittsburgh, Pittsburgh, PA, USA.
Jeanette
J
Trauth
University of Pittsburgh, Pittsburgh, PA, USA.
Edmund M
EM
Ricci
D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000175:diagnosis; D055088:Early Detection of Cancer / Q000706:statistics & numerical data; D004522:Educational Status; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006306:Health Surveys; D054625:Healthcare Disparities; D006801:Humans; D008327:Mammography / Q000706:statistics & numerical data*; D008875:Middle Aged; D015999:Multivariate Analysis; D065006:Papanicolaou Test / Q000706:statistics & numerical data*; D010349:Patient Compliance / Q000706:statistics & numerical data*; D010414:Pennsylvania; D012944:Social Support; D012959:Socioeconomic Factors; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis; D055815:Young Adult
breast cancer; cancer prevention and screening; health behavior; health disparities; women’s health