Demographic predictors of mammography and Pap smear screening in US women

Am J Public Health. 1993 Jan;83(1):53-60. doi: 10.2105/ajph.83.1.53.


Objectives: Proven screening technologies exist for both breast and cervical cancer, but they are underused by many women. We sought to evaluate the effect of demographic characteristics on the underuse of mammography and Pap smear screening.

Methods: We analyzed responses from 12,252 women who participated in the 1987 National Health Interview Survey Cancer Control Supplement. Demographic profiles were produced to target severely underserved groups of women.

Results: Low income was a strong predictor of mammography underuse, as was Hispanic ethnicity and other race, low educational attainment, age greater than 65, and residence in a rural area. A strong predictor of never having had a Pap smear was never having been married; however, the importance of this characteristic is difficult to interpret in the absence of data on sexual activity. Hispanic women and women of other races of all ages and all income levels underused Pap smear screening, as did older women, particularly older Black women.

Conclusions: The tendency of women to underuse screening technologies varies greatly across levels of basic demographic characteristics. The importance of these characteristics differs for mammography screening versus Pap smear screening.

MeSH terms

  • Adult
  • Aged
  • Educational Status
  • Employment
  • Ethnicity
  • Female
  • Humans
  • Mammography / statistics & numerical data*
  • Marital Status
  • Mass Screening / statistics & numerical data*
  • Middle Aged
  • Papanicolaou Test*
  • Patient Acceptance of Health Care / statistics & numerical data*
  • Social Class
  • United States
  • Urban Population
  • Vaginal Smears / statistics & numerical data*