title: Cervical Cancer Screening, Pelvic Examinations, and Contraceptive Use Among Adolescent and Young Adult Females.
abstract: OBJECTIVE
  The purpose of this study was to characterize the association between pelvic examination and adolescent contraceptive method use in two time periods in the 2006-2010 National Survey of Family Growth (NSFG).
  
  
  METHODS
  Using data from the 2006-2010 NSFG, we used descriptive statistics and multivariable regression models to examine the association between pelvic examination and/or Pap smear and use of effective or highly effective contraceptive methods during two time periods (2006-2008 and 2008-2010). We used the design characteristics of the NSFG to produce population estimates.
  
  
  RESULTS
  More than half (57.3%) of our target population reported that they had a pelvic examination and/or Pap smear in the preceding 12 months. After considering health service use, pregnancy history, and demographic characteristics, receipt of pelvic/Pap remained significantly associated with use of effective or highly effective methods of contraception. Adjusted odds ratio = 1.86; 95% confidence interval (CI), 1.17-2.97. When we examined the relationship between pelvic/Pap and use of effective or highly effective methods within time periods, we found that the odds of effective contraception use were higher among adolescents who had received a Pap/pelvic examination in Period 1 (June 2006-May 2008) but not in Period 2 (June 2008-May 2010). Odds ratio = 3.05; 95% CI, 1.53-6.03 and odds ratio = 1.52; 95% CI, .88-2.62, Periods 1 and 2 respectively.
  
  
  CONCLUSIONS
  This finding provides some reassurance that although indications for pelvic examination and Pap smear among adolescents have decreased, the previously documented association between pelvic examination and effective or highly effective contraception appears to have decreased.
authors.affiliation: Program on Women's Health Care Effectiveness Research, Department of Obstetrics and Gynecology, L4000 Women's Hospital, University of Michigan Medical School, Ann Arbor, Michigan.
authors.forename: Kavita S
authors.initials: KS
authors.lastname: Vinekar
authors.affiliation: Program on Women's Health Care Effectiveness Research, Department of Obstetrics and Gynecology, L4000 Women's Hospital, University of Michigan Medical School, Ann Arbor, Michigan.
authors.forename: Anjel
authors.initials: A
authors.lastname: Vahratian
authors.affiliation: Program on Women's Health Care Effectiveness Research, Department of Obstetrics and Gynecology, L4000 Women's Hospital, University of Michigan Medical School, Ann Arbor, Michigan; Institute for Social Research, Population Studies Center, University of Michigan, Ann Arbor, Michigan.
authors.forename: Kelli S
authors.initials: KS
authors.lastname: Hall
authors.affiliation: Survey Research Center and Center for Statistical Consultation and Research, University of Michigan, Ann Arbor, Michigan.
authors.forename: Brady T
authors.initials: BT
authors.lastname: West
authors.affiliation: Program on Women's Health Care Effectiveness Research, Department of Obstetrics and Gynecology, L4000 Women's Hospital, University of Michigan Medical School, Ann Arbor, Michigan.
authors.forename: Amy
authors.initials: A
authors.lastname: Caldwell
authors.affiliation: Program on Women's Health Care Effectiveness Research, Department of Obstetrics and Gynecology, L4000 Women's Hospital, University of Michigan Medical School, Ann Arbor, Michigan.
authors.forename: Jason D
authors.initials: JD
authors.lastname: Bell
authors.affiliation: Program on Women's Health Care Effectiveness Research, Department of Obstetrics and Gynecology, L4000 Women's Hospital, University of Michigan Medical School, Ann Arbor, Michigan. Electronic address: daltonvk@med.umich.edu.
authors.forename: Vanessa K
authors.initials: VK
authors.lastname: Dalton
mesh_terms: D000293:Adolescent; D000328:Adult; D003267:Contraception / Q000379:methods / Q000706:statistics & numerical data*; D003268:Contraception Behavior / Q000706:statistics & numerical data; D055088:Early Detection of Cancer / Q000379:methods* / Q000706:statistics & numerical data*; D005260:Female; D058869:Gynecological Examination / Q000379:methods / Q000706:statistics & numerical data*; D006801:Humans; D015999:Multivariate Analysis; D016017:Odds Ratio; D065006:Papanicolaou Test / Q000379:methods / Q000706:statistics & numerical data*; D011247:Pregnancy; D012044:Regression Analysis; D013997:Time Factors; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000517:prevention & control; D055815:Young Adult
keywords: Adolescents; Contraception; Pelvic examination