PREDICTORS OF PAP SMEAR SCREENING IN SOCIOECONOMICALLY DISADVANTAGED ELDERLY WOMEN

OBJECTIVE: The objective for this study was to identify predictors for participation in Pap smear screening in a socioeconomically disadvant aged older population. DESIGN AND SAMPLE: A cross-sectional survey des ign was used to examine data from 238 southern women 50 years of age a nd older who were recruited from 24 randomly selected congregate meal sites of the Council on Aging. MEASUREMENTS: The 45-item questionnaire covered demographics, Pap smear screening history, and colorectal can cer screening history. RESULTS: Among this older, very low income popu lation, women who had never had Pap smears (17.2%) were significantly more likely to have no phone or to be unable to use a phone (adjusted odds ratio (aOR) = 4.1; 95% confidence interval (CI) 1.6-10.6), to hav e annual incomes of less than $5,800 (aOR = 3.1; 95% CI 1.1-9.0), to b e widowed (aOR = 2.8; 95% CI 1.1-7.3), to have no family history of ca ncer (aOR = 3.3, 95% CI 1.3-10.0), to report having never had a rectal examination (aOR = 5.4, 95% CI 1.8-16.0), and not to have participate d in a free fecal occult blood testing program (aOR = 5.0, 95% CI 2.0- 10.0). CONCLUSIONS: These data, unique in including very low income (< $10,000) and older women (65 and over), found that income and access t o a phone were strongly correlated with cervical cancer screening part icipation. Women who lacked external incentives for screening (being w idowed and not having a family history of cancer) were less likely to obtain screening. This study's finding that ''not having a phone'' was a strong predictor for nonparticipation in cervical cancer screening has implications for national telephone-derived estimates of cervical cancer screening.