title: Non-utilization of the Pap Test Among Women with Frequent Health System Contact.
abstract: Despite improvements in health access, many underserved women abstain from cervical cancer screening. A self-administered questionnaire was used to identify factors determining whether medically underserved women attending a safety net health system regularly are screened for cervical cancer. Approximately 11 % of study subjects had never received a Pap test despite an average of nearly four clinic visits in the preceding 12 months. Never screeners were significantly younger, more likely to be Hispanic, non-U.S. born and less likely to have healthcare continuity. In multivariable analysis, odds for never screening were independently lower among women with male partner support (aOR 0.29) and physician's recommendation for screening (aOR 0.34) and higher among women who believed screening visits are too long (aOR 2.53). Educating male partners of Hispanic and immigrant women in addition to addressing recognized situational barriers may help to improve cervical cancer screening rates.
authors.affiliation: Department of Obstetrics and Gynecology, Baylor College of Medicine, One Baylor Plaza, BCM611, Houston, TX, 77030, USA.
authors.forename: Abayomi N
authors.initials: AN
authors.lastname: Ogunwale
authors.affiliation: Department of Obstetrics and Gynecology, Baylor College of Medicine, One Baylor Plaza, BCM611, Houston, TX, 77030, USA.
authors.forename: Haleh
authors.initials: H
authors.lastname: Sangi-Haghpeykar
authors.affiliation: Department of Pediatrics-Oncology, Baylor College of Medicine, One Baylor Plaza, Houston, TX, 77030, USA.
authors.forename: Jane
authors.initials: J
authors.lastname: Montealegre
authors.affiliation: Department of Obstetrics and Gynecology, Baylor College of Medicine, One Baylor Plaza, BCM611, Houston, TX, 77030, USA.
authors.forename: Yiwen
authors.initials: Y
authors.lastname: Cui
authors.affiliation: Dan L. Duncan Cancer Center, Baylor College of Medicine, One Baylor Plaza, Houston, TX, 77030, USA.
authors.forename: Maria
authors.initials: M
authors.lastname: Jibaja-Weiss
authors.affiliation: Department of Obstetrics and Gynecology, Pathology and Immunology, Dan L. Duncan Cancer Center, Center for Reproductive Biology, Baylor College of Medicine, One Baylor Plaza, BCM 611, Houston, TX, 77030, USA. matthew@bcm.edu.
authors.forename: Matthew L
authors.identifier: 0000-0002-2081-4672
authors.initials: ML
authors.lastname: Anderson
mesh_terms: D000328:Adult; D000367:Age Factors; D003430:Cross-Sectional Studies; D055088:Early Detection of Cancer / Q000379:methods; D054242:Emigrants and Immigrants / Q000706:statistics & numerical data; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D008875:Middle Aged; D065006:Papanicolaou Test / Q000706:statistics & numerical data*; D010342:Patient Acceptance of Health Care / Q000208:ethnology*; D064876:Safety-net Providers / Q000706:statistics & numerical data*; D012944:Social Support; D012959:Socioeconomic Factors; D018454:Spouses; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000208:ethnology* / Q000517:prevention & control
keywords: Cervical cancer; Male-partner support; Never-screened; Non-utilization; Pap test