title: Differences in cervical cancer screening knowledge, practices, and beliefs: An examination of survey responses.
abstract: Among the identified barriers to HPV vaccination is the concern that women may compensate for their reduced susceptibility to cervical cancers by reducing cervical cancer screening. This exploratory study examined the relationship between cervical cancer screening rates and HPV vaccination. We conducted a cross-sectional survey using a convenience sample of women aged 21-35 attending a local minority health fair in July 2015. Data were analyzed in 2015-2016. Outcomes assessed were: receiving a Pap test within the last three years, awareness and comfort with current Pap test recommendations, and knowledge regarding the purpose of a Pap test. A total of 291 women were included in the analyses. Mean age was 28.5 years and 62% were non-Hispanic black. 84% had received a Pap test in the last three years and 33% had received at least one HPV vaccine. Logistic regression results showed that women who had been vaccinated did not have lower odds of having a Pap test in the past three years (OR = 1.32; 95% CI = 0.66-2.65). In an adjusted regression model controlling for age and race, vaccinated women were significantly more likely to have had a Pap test (AOR = 3.06; 95% CI = 1.37-6.83). Yet only 26% of women knew the purpose of a Pap test and the proportion who answered correctly was higher among non-Hispanic white women. Women who have been vaccinated for HPV are more likely to have been screened for cervical cancer. These results suggest areas for more robust studies examining pro-health attitudes, behaviors, and communication regarding vaccination and preventive screening.
authors.affiliation: Indiana University Richard M. Fairbanks School of Public Health, Department of Epidemiology, 1050 Wishard Blvd, RG5, Indianapolis, IN 46202, USA.
authors.forename: Monica L
authors.initials: ML
authors.lastname: Kasting
authors.affiliation: Indiana University School of Medicine, Department of Pediatrics, 410 W 10th Street Suite 1001, Indianapolis, IN 46202, USA.
authors.forename: Shannon
authors.initials: S
authors.lastname: Wilson
authors.affiliation: Indiana University Richard M. Fairbanks School of Public Health, Department of Epidemiology, 1050 Wishard Blvd, RG5, Indianapolis, IN 46202, USA.
authors.forename: Terrell W
authors.initials: TW
authors.lastname: Zollinger
authors.affiliation: Indiana University Richard M. Fairbanks School of Public Health, Department of Epidemiology, 1050 Wishard Blvd, RG5, Indianapolis, IN 46202, USA; Regenstrief Institute, Inc., Center for Biomedical Informatics, 1101 W. 10th St., Indianapolis, IN 46202, USA; Center for Health Information and Communication, Department of Veterans Affairs, Veterans Health Administration, Health Services Research and Development Service CIN 13-416, 1481 W. 10th St, 11H, Indianapolis, IN 46202, USA.
authors.forename: Brian E
authors.initials: BE
authors.lastname: Dixon
authors.affiliation: Indiana University School of Medicine, Department of Pediatrics, 410 W 10th Street Suite 1001, Indianapolis, IN 46202, USA.
authors.forename: Nathan W
authors.initials: NW
authors.lastname: Stupiansky
authors.affiliation: Indiana University School of Medicine, Department of Pediatrics, 410 W 10th Street Suite 1001, Indianapolis, IN 46202, USA.
authors.forename: Gregory D
authors.initials: GD
authors.lastname: Zimet
keywords: Health behaviors; Health disparities; Papanicolaou test; Papillomavirus vaccines; Risk compensation