Pap testing in college women: Individual behaviors and characteristics as important factors

Background. The Pap test has contributed to the decline in incidence and mortality from cervical cancer. Pap testing, recommended for all women aged >21 years, may be low in college women. In this study, we determined Pap testing rates and identified associated individual behaviors and characteristics in college women.

Objective. To determine Pap testing rates and assess individual characteristics associated with Pap testing.

Methods. A convenience sample of 351 women aged 22 and above (59% White; mean age of 26) recruited from a university campus completed a questionnaire in 2011. Bivariate and multivariate analyses adjusted for condom use and race were performed.

Results. Prevalence of ever having a Pap test was 83%. Women were significantly (P<0.05) more likely to undergo a Pap test if they were white (93% vs. 65% for blacks), reported condom use (89% vs. 80%), had > 5 vaginal sex partners (100% vs. 83%) or smoked cigarettes/marijuana > 3 times weekly (95% vs. 82%) within the past year. No significant association was found with any history of STDs or HPV vaccination. In the multivariate model, women were more likely to have a Pap test if they reported condom use (OR=2.9, 95% CI 1.4-6.2) and whites were more likely to have a Pap test than blacks (OR=7.2, 95% CI 2.9-17.6)

Conclusion. We found that 17% of college women >22yrs have never had a Pap test. Strategies that target minority women and those with few sex partners will be valuable in improving Pap testing rates in college women.