CERVICAL-CANCER SCREENING IN HOSPITALS - THE EFFICACY OF LEGISLATION IN MARYLAND

Objectives. The purpose of the study was to examine the efficacy of a Maryland law requiring Pap testing to be offered during hospital admis sions. ''In-reach'' strategies emphasize cancer screening within exist ing health care contacts (such as inpatient stays) rather than additio nal visits solely for screening.Methods. Data from a 1986 telephone su rvey of Maryland women were used to examine the effect of hospitalizat ion on self-reported Pap testing in a 3-year period. The effect of hos pitalization on screening was examined by age and income to assess whe ther inpatient screening was more prevalent among certain subgroups of women. Results. For the group as a whole, the odds of Pap screening d id not vary with hospitalization. However, among women aged 45 to 54 y ears with annual household incomes over $20 000, hospitalized women we re more likely than nonhospitalized women to report recent Pap tests. For low-income women aged 75 years and older, hospitalization actually decreased the likelihood of reporting Pap tests. Conclusions. Despite legislation, inpatient cervical cancer screening appears to mirror ou tpatient patterns, leaving elderly and low-income women unscreened. Me thods for increasing inpatient Pap testing for underscreened women are discussed.