Changes in cervical cancer screening behavior for women attending Pap Test Week clinics

Abstract

V Poliquin,1 K Decker,2,3 AD Altman,1,2,4 R Lotocki1,2,4 1Department of Obstetrics, Gynecology and Reproductive Sciences, University of Manitoba, Canada; 2CancerCare Manitoba, Winnipeg, Manitoba, Canada; 3Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, 4Division of Gynecologic Oncology, University of Manitoba, Winnipeg, Manitoba, Canada Objective: This retrospective study of all women who accessed the 2006 Manitoba Pap Test Week clinics was designed to determine factors associated with inadequate cervical cancer screening and changes in cervical cancer screening behavior. Methods: Data were acquired using the CervixCheck Manitoba registry and an ancillary database of demographic information collected from clinic attendees. Results: The study included 1124 women. Of these, 53% (n = 598) were under-screened (no Pap test in the previous 2 years) prior to accessing the clinics. Logistic regression analyses demonstrated that older age (odds ratio [OR] = 1.02, 95% confidence interval [CI] 1.01–1.03), no doctor (OR = 1.4, 95% CI 1.05–1.54), and living in Canada < 1 year (OR = 5.5, 95% CI 2.73–11.12) were associated with being under-screened prior to accessing the Pap Test Week clinics. Thirty-seven percent (n = 223) of under-screened women demonstrated improved screening status subsequent to the 2006 Pap Test Week (had a subsequent Papanicolaou [Pap] test performed within 2 years) and these women were more likely to live in an urban setting (P = 0.003), be younger (P < 0.001), originate outside Canada (P = 0.006), have lived in Canada for less than 1 year (P = 0.006), and have had an abnormal Pap test result in 2006 (P < 0.001). Previously under-screened women were less likely to become adequately-screened subsequent to 2006 if they had a Pap test performed at a Pap Test Week clinic compared to having a Pap test performed elsewhere (37% versus 60%, P < 0.001). Conclusion: This study identified a subset of under-screened women accessing Pap Test Week clinics whose screening status might be most modifiable. Keywords: health promotion campaign, prevention, cervical cancer, risk assessment, public screening program