Risk factors that Contribute to a Decreased Likelihood of Obtaining Pap Screening

Background: Cervical pap screening significantly decreases mortality from cervical cancer. Human papillomavirus (HPV) is responsible for the majority of diagnosed cases of cervical cancer. However, not all at risk women in the United States obtain pap screening. Previous research has suggested that knowledge regarding HPV may influence the likelihood of pap screening. More information is needed on risk factors that may prevent women from obtaining cervical pap screening, including knowledge of HPV. The purpose of this study was to identify risk factors that contribute to a decreased likelihood of obtaining pap screening. Methods: Data was obtained from the 2007 California Health Interview Survey (CHIS). Women, aged 18 to 80, who responded to questions related to the study objectives were included (N=1,666). Multivariate logistic regression was used to identify variables that significantly predicted pap screening. Variables examined included demographic variables, insurance status, health status, and HPV knowledge. Results: In the full model, significant risk factors of having never had cervical pap screening were self-identification as Asian (Adjusted Odds Ratio (AOR) 4.48, 95% CI, 2.95-6.80); lack of knowledge of HPV (AOR 2.93, 95% CI, 1.72-4.97), belief that HPV causes AIDS (AOR, 1.88, 95% CI, 1.280-2.751) being unmarried (AOR 13.932, 95% CI, 7.275-26.690), and uninsured status (AOR 1.62, 95% CI, 1.178-2.219). Conclusions: In this CHIS sample, we found that Asian women report obtaining pap screening less frequently than other women in the sample. We identified important predictors of not obtaining pap screening in California women, including a lack of awareness about HPV risk.