MAMMOGRAPHY AND PAP SMEAR SCREENING OF YAQUI INDIAN WOMEN

The Pascua-Yaqui Tribe of Arizona receives its health care services al a local neighborhood health center in Tucson and a satellite clinic l ocated on the reservation. Using a computerized data base from the hea lth center, the authors determined the use rates by Pascua-Yaqui women ages 35-65 of the Papanicolaou smear and mammography screening. Among active users of the health center, 31-36 percent had received a Papan icolaou smear, according to the yearly data bases examined from 1986 t o 1990, while 65 percent of the women had received at least one smear test over the entire 5-year period. Regarding mammography screening, 4 1-43 percent of the women ages 50-65 had received a mammogram in the y ears studied, and 51-58 percent of the women ages 40-49 had been scree ned. In all, 67 percent had received at least one mammogram during the 1988-90 period when the center offered mammography. This population o f 35-65-year-old American Indian women, for whom financial access is n ot a barrier, were receiving Papanicolaou smears and mammograms at rat es comparable with other segments of the U.S. population but at lower rates than those recommended by the American Cancer Society and Nation al Cancer Institute. The challenge for the health center is to reach t hose women who are eligible for services but do not use them and to ad dress the nonfinancial barriers to care such as language, transportati on, and gender-specific issues.