Racial/ethnic disparities, body weight, and psychosocial antecedents that predict women’s failure to meet Pap test screening national recommendations

Rachel Mahas, Jiunn-Jye Sheu, Shipra Singh, Timothy Jordan, Andrew Geers


Background: The economic burden associated with cervical cancer in the U.S. is estimated 300–400 million
dollars in direct costs. Healthy People 2020 Objective C-15 points the nation’s aim to increase the proportion of adult women who receive a cervical cancer screening to 93%. To identify the associated factors that can help increase Pap test, this study examined the predictors of failure to meet USPSTF Pap test recommendation among adult women.
Methods: We analyzed the 2014 National Cancer Institute’s nationally representative Health Information National Trends Survey (HINTS) 4 Cycle 4 data (N=3,677). Adult women who were 21 to 65 years of age and not diagnosed with cervical cancer were included in this analysis. Stepwise multiple logistic regression was conducted to predict the behavioral and demographic factors associated with failure to meet USPSTF Pap test recommendation.
Results: Women with the following characteristics tend to fail to meet the Pap test national recommendation with statistical significance: (I) being Asian or White (vs. Hispanic); (II) being underweight or of normal weight (vs. overweight/obese); (III) having more symptoms of depression and anxiety within the past two years; (IV) never being diagnosed with cancer; (V) fail to meet USPSTF mammography recommendation (vs. met); (VI) having last routine check-up by a doctor more than 2 years (vs. within 2 years); (VII) being older than 35 (vs. aged 21–35); (VIII) being single, divorced/separated, or widowed (vs. married/living as married); and (IX) having less education (vs. college graduate or more).
Conclusions: This study identified racial/ethnic disparities in women who failed to meet the Pap test screening national recommendation. Additionally, symptoms of depression and anxiety and being underweight or of normal weight (vs. overweight) were identified as significant predictors to failing to meet Pap test screening national recommendations. These findings may be used to identify future cervical cancer screening priority populations and direction for further intervention.