Is there a language divide in pap test use?

Med Care. 2006 Nov;44(11):998-1004. doi: 10.1097/01.mlr.0000233676.61237.ef.


Objective: We sought to determine whether primary language use, measured by language of interview, is associated with disparities in cervical cancer screening.

Data sources: We undertook a secondary data analysis of a pooled sample of the 2001 and 2003 California Health Interview Surveys. The surveys were conducted in English, Spanish, Cantonese, Mandarin, Korean, and Vietnamese.

Study design: The study was a cross-sectional analysis of 3-year Pap test use among women ages 18 to 64, with no reported cervical cancer diagnosis or hysterectomy (n = 38,931). In addition to language of interview, other factors studied included race/ethnicity, marital status, income, educational attainment, years lived in the United States, insurance status, usual source of care, smoking status, area of residence, and self-rated health status.

Data collection/extraction methods: We fit weighted multivariate logit models predicting 3-year Pap test use as a function of language of interview, adjusting for the effects of specified covariates.

Principal findings: Compared with the referent English interview group, women who interviewed in Spanish were 1.65 times more likely to receive a Pap test in the past 3 years. In contrast, we observed a significantly reduced risk of screening among women who interviewed in Vietnamese (odds ratio [OR] 0.67; confidence interval [CI] 0.48-0.93), Cantonese (OR 0.44; 95% CI 0.30-0.66), Mandarin (OR 0.48; 95% CI 0.33-0.72), and Korean (OR 0.62; 0.40-0.98).

Conclusions: Improved language access could reduce cancer screening disparities, especially in the Asian immigrant community.

Publication types

  • Comparative Study
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Adult
  • Confidence Intervals
  • Cross-Sectional Studies
  • Emigration and Immigration*
  • Ethnicity
  • Female
  • Health Status
  • Health Surveys
  • Humans
  • Interviews as Topic
  • Language*
  • Mass Screening / statistics & numerical data
  • Middle Aged
  • Multivariate Analysis
  • Racial Groups
  • Regression Analysis
  • Socioeconomic Factors
  • Time Factors
  • United States / ethnology
  • Uterine Cervical Neoplasms / prevention & control*
  • Vaginal Smears / statistics & numerical data*