Cervical Cancer Screening Barriers and Risk Factor Knowledge Among Uninsured Women.
A steady decline in cervical cancer incidence and mortality in the United States has been attributed to increased uptake of cervical cancer screening tests such as Papanicolau (Pap) tests. However, disparities in Pap test compliance exist, and may be due in part to perceived barriers or lack of knowledge about risk factors for cervical cancer. This study aimed to assess correlates of cervical cancer risk factor knowledge and examine socio-demographic predictors of self-reported barriers to screening among a group of low-income uninsured women. Survey and procedure data from 433 women, who received grant-funded cervical cancer screenings over a span of 33 months, were examined for this project. Data included demographics, knowledge of risk factors, and agreement on potential barriers to screening. Descriptive analysis showed significant correlation between educational attainment and knowledge of risk factors (r = 0.1381, P < 0.01). Multivariate analyses revealed that compared to Whites, Hispanics had increased odds of identifying fear of finding cancer (OR 1.56, 95% CI 1.00-2.43), language barriers (OR 4.72, 95% CI 2.62-8.50), and male physicians (OR 2.16, 95% CI 1.32-3.55) as barriers. Hispanics (OR 1.99, 95% CI 1.16-3.44) and Blacks (OR 2.06, 95% CI 1.15-3.68) had a two-fold increase in odds of agreeing that lack of knowledge was a barrier. Identified barriers varied with age, marital status and previous screening. Programs aimed at conducting free or subsidized screenings for medically underserved women should include culturally relevant education and patient care in order to reduce barriers and improve screening compliance for safety-net populations.
Department of Health Policy & Management, Texas A&M School of Public Health, TAMU 1266, College Station, TX, 77843-1266, USA. akinlotan@sph.tamhsc.edu.
Marvellous
http://orcid.org/0000-0002-3919-889X
M
Akinlotan
Department of Health Policy & Management, Texas A&M School of Public Health, TAMU 1266, College Station, TX, 77843-1266, USA.
Jane N
JN
Bolin
Department of Health Policy & Management, Texas A&M School of Public Health, TAMU 1266, College Station, TX, 77843-1266, USA.
Janet
J
Helduser
Department of Health Sciences, University of Missouri, Columbia, MO, 65211, USA.
Chinedum
C
Ojinnaka
Department of Clinical Translational Medicine, College of Medicine, Texas A&M Health Science Center, 2900 E. 29th Street, Bryan, TX, 77802, USA.
Anna
A
Lichorad
Department of Clinical Translational Medicine, College of Medicine, Texas A&M Health Science Center, 2900 E. 29th Street, Bryan, TX, 77802, USA.
David
D
McClellan
D000293:Adolescent; D000328:Adult; D055088:Early Detection of Cancer / Q000706:statistics & numerical data*; D005239:Fear; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D017057:Medically Uninsured / Q000208:ethnology*; D008875:Middle Aged; D065006:Papanicolaou Test; D044469:Racial Groups; D012307:Risk Factors; D012959:Socioeconomic Factors; D014481:United States; D002583:Uterine Cervical Neoplasms / Q000208:ethnology* / Q000517:prevention & control*; D055815:Young Adult
Barriers; Cervical cancer; Knowledge; Screening; Uninsured