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Published Online: 1 February 2012

Adherence Over Time to Cervical Cancer Screening Guidelines: Insights From the Canadian National Population Health Survey

Publication: Journal of Women's Health
Volume 21, Issue Number 2

Abstract

Background: A substantial percentage of North American women are nonadherent to cervical cancer screening guidelines despite the effectiveness of the Papinicolaou (pap) test for papillomavirus. Our objective was to determine factors associated with changes in adherence for cervical cancer screening guidelines over a 14-year period.
Methods: Using data from cycles 1 (1994–1995) through 7 (2006–2007) of the Canadian National Population Health Survey, we used logistic regression to compare the regularity of pap testing (at least once every 36 months) among women. We compared women with increasing adherence to pap testing guidelines to those who were never adherent, and women with decreasing adherence to those who were always adherent. The sample included women aged 20–70 years who responded in at least three of seven waves of data collection and had not undergone a hysterectomy (n=4949). Independent variables were based on Andersen's Behavioral Model of predisposing, enabling, and need variables.
Results: The majority of our sample were either always adherent (61.4%) or had increasing adherence (9.9%) over the course of the study. Another 4.8% were never adherent, and 6.6% had decreasing adherence over their involvement in the study. Predominantly, both enabling (e.g., presence of regular doctor) and need (e.g., birth control pill use, obesity) factors were associated with changing patterns of adherence.
Conclusions: Physicians have a crucial role to play in the trajectories of adherence to cervical cancer screening guidelines over time. In addition, women with obesity need to be particularly targeted for services because they are vulnerable to negative trajectories in adherence over time.

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Published In

cover image Journal of Women's Health
Journal of Women's Health
Volume 21Issue Number 2February 2012
Pages: 199 - 208
PubMed: 21988527

History

Published in print: February 2012
Published online: 1 February 2012
Published ahead of print: 11 October 2011

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Affiliations

Catherine Worthington
School of Public Health and Social Policy, University of Victoria, Victoria, British Columbia, Canada.
Kendra McLeish
Department of Economics, University of Calgary, Calgary, Alberta, Canada.
Esme Fuller-Thomson
Sandra Rotman Chair, Factor-Inwentash Faculty of Social Work, University of Toronto, Toronto, Ontario, Canada.

Notes

Address correspondence to:Esme Fuller-Thomson, M.S.W., Ph.D.Factor-Inwentash Faculty of Social WorkUniversity of Toronto246 Bloor Street WestToronto, ON M5S 1A1Canada
E-mail: [email protected]

Disclosure Statement

No competing financial interests exist.

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