Social conservatism, reproductive health practices, and cervical cancer screening

Background: Cervical cancer, one of the most common types of gynecologic cancer, is characterized by malignant cells formed in cervical tissue. Cervical cancer incidence rates in the U.S. from 1998-2002 were 8.7 per 100,000 for Whites, 11.1 per 100,000 for African Americans, and 15.8 per 100,000 for Hispanics. Cervical cancer is preventable and treatable if detected early using a Pap test.

Methods: Data from the 2002 National Survey of Family Growth (n=7643) were analyzed using multivariate logistic regression. According to our conceptual model, a woman's likelihood of engaging in cervical cancer screening behavior is a function of several variables including the psychosocial construct of “Reproductive Body Image”, which we defined as a complex interaction between a woman's reproductive health practices specifically vaginal douching, sexual risk behaviors, and a woman's cultural beliefs.

Results: After adjustment for control variables, women who indicated conservative beliefs about marriage and gender roles were significantly less likely to report having a yearly Pap test than their more liberal counterparts (OR=0.85, 0.86, respectively). Women who reported somewhat regular douching in the last year were significantly more likely to report having a Pap test than women who reported never douching (OR=1.22). Other dimensions of reproductive body image were not significant predictors.

Conclusion: Innovative health education programs aimed at socially conservative women are needed to increase rates of cervical cancer screening and adherence to screening guidelines. Further research is needed to examine the interaction of race and income on these social attitudes and their influence on screening behaviors.