FACTORS ASSOCIATED WITH NONUSE OF PAPTEST - A POPULATION SURVEY

Background: Cervical cancer is the most important cancer in Mexican wo men. Early detection is possible by means of the Papanicolaou (Pap) te st; however, the coverage in Mexico is low. Methods: A cross-sectional survey was carried out in a representative sample of women from the T lalpan area of Mexico City. Social, reproductive and health care facto rs associated with the lack of use of the Pap test with respect to ade quate use and misuse were identified. Both bivariate and logistic regr ession analyses were used for the adjustment of variables. Results: Of 1,215 women studied, 22.5% had never had a Pap smear, 42% had misused the test (<90% of triennial performance), and 35.5% had adequately us ed the test (greater than or equal to 90% of triennial performance). T he main factors related to the lack of use were the following: not kno wing about the Pap test (ORa = 35.16, 95% C.I.=17.4 - 70.9); having fe wer than 6 years of education (ORa = 4.5, 95 % C.I. = 2.5 - 8.4) women younger than 30 years of age (ORa = 3.495% C.I. = 2.3 - 5.1); use of contraceptives (ORa = 0.4, 95 % C.I. = 0.2 - 0.8); history of sexually transmitted diseases (ORa = 0.3, 95% C.I. = 0.1 - 0.8), and the princ ipal informant about the Pap test, i.e., the health services personnel (ORa = 0.02, 95% C.I. = 0.0008 - 11.05). Conclusions: The lack of use and the misuse of Pap smears vary importantly among the different soc ial and reproductive factors. But the principal reasons for lack of us e were not knowing about the Pap test and a low educational level. We propose a greater diffusion on the benefits of the test in the Mexican population, through massive means of communication and health service s.