CANCER SCREENING PRACTICES AMONG WOMEN IN A COMMUNITY-HEALTH CENTER POPULATION

Background: Cancer takes a disproportionate toll on disadvantaged Amer icans. Poverty and low education are risk factors for underuse of canc er screening. Methods: In this report, we discuss predictors of adhere nce to cancer screening (mammography, clinical breast exam [CBE], and Pap tests) among 926 women who receive care at a community health cent er that serves a predominantly low-income and minority population. We examine predictors for each of the tests and for a composite measure o f overall cancer screening test compliance. In studying multiple scree ning behaviors we not only investigate factors associated with each in dividual behavior, but we also identify consistently effective factors across several behaviors. Results: The analysis indicates consistent effects of age, education, and insurance status on cancer screening. I n addition, decisional balance, a measure of a person's beliefs about the pros and cons of complying with the screening test, is associated strongly with adherence. We have extended earlier findings about the p ositive relationship between decisional balance and mammography to inc lude decisional balance and Pap tests, as well. This finding suggests that behavioral interventions that target decisional balance can effec tively promote adherence to cancer screening tests.