Recency of Pap testing and future testing plans among women aged 18-64: analysis of the 2007 Health Information National Trends Survey

Abstract

Background: Cervical cancer incidence has declined as a result of Papanicolaou (Pap) test use. Current guidelines recommend increasing screening intervals for women of average risk. The objective of this study is to examine current screening intervals, factors associated with recency of Pap testing, and future testing plans.

Methods: We analyzed data from 2915 female respondents, aged 18-64, using the 2007 Health Information National Trends Survey (HINTS), a biennial national survey of access and use of cancer information in the United States. We divided time since last Pap test into ≤1 year (n=1960), >1 to ≤3 years (n=512), >3 years/never had Pap test (n=443). We performed univariate analyses and multivariate logistic regression, using proportional odds model with cumulative logit link.

Results: Sixty-five percent of women had their most recent Pap test within 1 year. Most expected to be screened again within 1 year (81%). This expectation was highest among women who were tested within the previous year (90.9%). Having had a test within 1 year was positively associated with age groups 31-45 vs. 46-64 years; with being non-Hispanic black vs. non-Hispanic white; with being a college graduate vs. having less education; with being married, divorced, or separated vs. widowed; with having at least one visit to a healthcare provider in the past year; and with being aware of the human papillomavirus (HPV).

Conclusions: Most women currently are tested and anticipate future testing at annual intervals. To implement guidelines, increased communication and systematic or policy changes may be needed to reduce overtesting.