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Canadian Journal of Public Health = Revue Canadienne de Santé Publique logoLink to Canadian Journal of Public Health = Revue Canadienne de Santé Publique
. 2001 Mar 1;92(2):127–133. doi: 10.1007/BF03404946

Factors Important in Promoting Cervical Cancer Screening among Canadian Women: Findings from the 1996–97 National Population Health Survey (NPHS)

Colleen J Maxwell 113,, Christina M Bancej 213, Judy Snider 213, Shelly A Vik 313
PMCID: PMC6979945  PMID: 11338151

Abstract

Although routine Pap screening represents an effective tool in the early detection of cervical cancer, it remains underused by some Canadian women. This study examines selected sociodemographic, health, lifestyle, and system barriers to Pap test participation among 33,817 women aged 18+ years in the cross-sectional 1996–97 National Population Health Survey (NPHS).

Among women 18 years and over, 87% reported ever having had a Pap test while 72% reported a recent (<3 years) test. A report of ever and recent use was most common among women 25–34 (92% and 86.9%, respectively). Only 0.6% of recently screened women reported access problems. Among those without a recent test, most (53%) reported that they did not think it was necessary. Pap test use varied little across provinces and was less common among older and single women, those with lower education, a spoken language other than English, a birth place outside Canada and negative health and lifestyle characteristics.

References

  • 1.National Cancer Institute of Canada. Canadian Cancer Statistics 2000. 2000. [Google Scholar]
  • 2.Canadian Task Force on the Periodic Health Examination. The Canadian Guide to Clinical Preventive Health Care. Ottawa: Minister of Supply and Service, Health Canada; 1994. Screening for cervical cancer. [Google Scholar]
  • 3.Quality Management Working Group–Cervical Cancer Prevention Network. Programmatic Guidelines for Screening for Cancer of the Cervix in Canada. Ottawa: Society of Gynecologic Oncologists of Canada; 1998. [Google Scholar]
  • 4.Health Canada, Laboratory Centre for Disease Control. Cancer Updates: Cervical Cancer in Canada. Ottawa: Health Canada (LCDC); 1998. [Google Scholar]
  • 5.Parboosingh EJ, Anderson G, Clarke EA, et al. Cervical cancer screening: Are the 1989 recommendations still valid? Can Med Assoc J. 1996;154:1847–53. [PMC free article] [PubMed] [Google Scholar]
  • 6.Miller AB, Anderson G, Brisson J, et al. Report of the National Workshop on Screening for Cancer of the Cervix. Can Med Assoc J. 1991;145:1301–25. [PMC free article] [PubMed] [Google Scholar]
  • 7.Stuart GC, McGregor E, Duggan MA, Nation JG. Review of the screening history of Alberta women with invasive cervical cancer. Can Med Assoc J. 1997;157:513–19. [PMC free article] [PubMed] [Google Scholar]
  • 8.Rolnick S, LaFerla JJ, Wehrle D, et al. Pap smear screening in a health maintenance organization: 1986–1990. Prev Med. 1996;25:156–61. doi: 10.1006/pmed.1996.0041. [DOI] [PubMed] [Google Scholar]
  • 9.Higgins C. Practice. Screening for cervical cancer. Nursing Times. 1997;93(20):50–51. [PubMed] [Google Scholar]
  • 10.Rosenthal AN. Screening for gynecologic cancers. Current Opinion in Oncology. 1998;10:447–51. doi: 10.1097/00001622-199809000-00013. [DOI] [PubMed] [Google Scholar]
  • 11.Maxwell CJ, Kozak JF, Desjardins-Denault S. Factors important in promoting cervical cancer screening behaviours among Canadian women: Regional comparisons. Ottawa: Disease Prevention Division, Health Canada; 1996. [Google Scholar]
  • 12.Lee J, Parsons GF, Gentleman JF. Falling short of Pap test guidelines. Health Reports. 1998;10:9–19. [PubMed] [Google Scholar]
  • 13.Simoes EJ, Newschaffer CJ, Hagdrup N, et al. Predictors of compliance with recommended cervical cancer screening schedule: A populationbased study. J Community Health. 1999;24:115–30. doi: 10.1023/A:1018754307718. [DOI] [PubMed] [Google Scholar]
  • 14.Anderson LM, May DS. Has the use of cervical, breast, and colorectal cancer screening increased in the United States? Am J Public Health. 1995;85:840–42. doi: 10.2105/AJPH.85.6.840. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 15.Snider JA, Beauvais JE. Pap smear utilization in Canada: Estimates after adjusting the eligible population for hysterectomy status. Chron Dis Can. 1998;19:19–24. [PubMed] [Google Scholar]
  • 16.Martin LM, Calle EE, Wingo PA, Heath CW. Comparison of mammography and pap test utilization from the 1987 and 1992 National Health Interview Surveys: Are we closing the gaps? Am J Prev Med. 1996;12:82–90. doi: 10.1016/S0749-3797(18)30349-0. [DOI] [PubMed] [Google Scholar]
  • 17.Tamblay JL, Catlin G. Sample design of the National Population Health Survey. Health Reports. 1995;7:29–38. [PubMed] [Google Scholar]
  • 18.Swain L, Catlin G, Beaudet MG. The National Population Health Survey–Its longitudinal nature. Health Reports. 1999;10:69–82. [PubMed] [Google Scholar]
  • 19.Statistics Canada. National Population Health Survey 1996–97: Household Component User’s Guide for the Public Use Microdata Files (Cat. No. 82M0009GPE) Ottawa: Ministry of Industry; 1998. [Google Scholar]
  • 20.Kelsey JL, Whittemore AS, Evans AS, Thompson WD. Methods in Observational Epidemiology. 2nd. New York: Oxford University Press; 1996. [Google Scholar]
  • 21.SAS Institute Inc. SAS User’s Guide, release 6.12 for Windows. Cary, NC: SAS Institute; 1996. [Google Scholar]
  • 22.Weinrich S, Coker AL, Weinrich M, et al. Predictors of Pap smear screening in socioeconomically disadvantaged elderly women. J Am Geriatr Soc. 1995;43:267–70. doi: 10.1111/j.1532-5415.1995.tb07336.x. [DOI] [PubMed] [Google Scholar]
  • 23.Calle EE, Flanders WD, Thun MJ, Martin LM. Demographic predictors of mammography and Pap smear screening in US women. Am J Public Health. 1993;83:53–60. doi: 10.2105/AJPH.83.1.53. [DOI] [PMC free article] [PubMed] [Google Scholar]
  • 24.Cockburn J, White VM, Hirst S, Hill D. Barriers to cervical screening in older women. Aust Fam Physician. 1992;21:973–78. [PubMed] [Google Scholar]
  • 25.Rimer BK. Audiences and messages for breast and cervical cancer screenings. Wellness Perspectives: Research, Theory, Practice. 1995;11:13–39. [Google Scholar]
  • 26.Rimer BK. Improving the use of cancer screening for older women. Cancer. 1993;72:1084–87. doi: 10.1002/1097-0142(19930801)72:3+&#x0003c;1084::AID-CNCR2820721324&#x0003e;3.0.CO;2-F. [DOI] [PubMed] [Google Scholar]
  • 27.Breslow RA, Sorkin JD, Frey CM, Kessler LG. Americans’ knowledge of cancer risk and survival. Prev Med. 1997;26:170–77. doi: 10.1006/pmed.1996.0136. [DOI] [PubMed] [Google Scholar]
  • 28.Mandelblatt J, Gopul I, Wistreich M. Gynecological care of elderly women: Another look at Papanicolaou smear testing. JAMA. 1986;256:367–71. doi: 10.1001/jama.1986.03380030069030. [DOI] [PubMed] [Google Scholar]
  • 29.Mandelblatt J, Traxler M, Lakin P, et al. Mammography and Papanicolaou smear use by elderly poor black women. The Harlem Study Team. J Am Geriatr Soc. 1992;40:1001–7. doi: 10.1111/j.1532-5415.1992.tb04476.x. [DOI] [PubMed] [Google Scholar]
  • 30.Branoff R, Santi K, Campbell JK, et al. A family practice residency cervical screening project: Perceived screening barriers. Family Med. 1997;29(2):119–23. [PubMed] [Google Scholar]
  • 31.Wilcox LS, Mosher WD. Factors associated with obtaining health screening among women of reproductive age. Public Health Rep. 1993;108:76–86. [PMC free article] [PubMed] [Google Scholar]
  • 32.Lesjak M, Ward J, Rissel C. Cervical screening of Arabic-speaking women in Australian general practice. J Med Screening. 1997;4:107–11. doi: 10.1177/096914139700400208. [DOI] [PubMed] [Google Scholar]
  • 33.McPhee SJ, Bird JA, Davis T, et al. Barriers to breast and cervical cancer screening among Vietnamese-American women. Am J Prev Med. 1997;13(3):205–13. doi: 10.1016/S0749-3797(18)30195-8. [DOI] [PubMed] [Google Scholar]
  • 34.Tang TS, Solomon LJ, Yeh CJ, Worden JK. The role of cultural variables in breast self-examination and cervical cancer screening behavior in young Asian women living in the United States. J Behav Med. 1999;22:419–36. doi: 10.1023/A:1018653306776. [DOI] [PubMed] [Google Scholar]
  • 35.Hislop TG, Clarke HF, Deschamps M, et al. Cervical cytology screening. How can we improve rates among First Nations women in urban British Columbia? Can Fam Phys. 1996;42:1701–8. [PMC free article] [PubMed] [Google Scholar]
  • 36.Lazcano-Ponce EC, Castro R, Allen B, et al. Barriers to early detection of cervical-uterine cancer in Mexico. J Womens Health. 1999;8:399–408. doi: 10.1089/jwh.1999.8.399. [DOI] [PubMed] [Google Scholar]
  • 37.Seow A, Wong ML, Smith WC, Lee HP. Beliefs and attitudes as determinants of cervical cancer screening: A community-based study in Singapore. Prev Med. 1995;24:134–41. doi: 10.1006/pmed.1995.1026. [DOI] [PubMed] [Google Scholar]
  • 38.Suarez L, Roche RA, Nichols D, Simpson DM. Knowledge, behavior, and fears concerning breast and cervical cancer among older low-income Mexican-American women. Am J Prev Med. 1997;13(2):137–42. doi: 10.1016/S0749-3797(18)30211-3. [DOI] [PubMed] [Google Scholar]
  • 39.Thommasen H, Lenci P, Brake I, Anderson G. Cervical cancer screening performed by a nurse. Can Fam Phys. 1996;42:2179–83. [PMC free article] [PubMed] [Google Scholar]
  • 40.Hernandez-Hernandez DM, Garcia-Elizondo MR, Ornelas-Bernal L, et al. Factors associated with non-use of Pap test. A population survey. Arch Med Res. 1998;29:263–70. [PubMed] [Google Scholar]
  • 41.Mandelblatt JS, Gold K, O’Malley AS, et al. Breast and cervix cancer screening among multiethnic women: Role of age, health, and source of care. Prev Med. 1999;28:418–25. doi: 10.1006/pmed.1998.0446. [DOI] [PubMed] [Google Scholar]
  • 42.Rakowski W, Clark MA, Ehrich B. Smoking and cancer screening for women aged 42–75: Associations in the 1990–1994 National Health Interview Surveys. Prev Med. 1999;29:487–95. doi: 10.1006/pmed.1999.0578. [DOI] [PubMed] [Google Scholar]
  • 43.Nosek MA, Howland CA. Breast and cervical cancer screening among women with physical disabilities. Arch Phys Med Rehab. 1997;78(12):S39–44. doi: 10.1016/S0003-9993(97)90220-3. [DOI] [PubMed] [Google Scholar]
  • 44.Nosek MA. MMWR. 1998. Use of cervical and breast cancer screening among women with and without functional limitations–United States, 1994–1995; pp. 853–55. [PubMed] [Google Scholar]

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