Pap smear screening among urban southwestern American Indian women

Background. American Indian women have among the highest incidence and mort ality rates of cervix cancer in the United States. The incidence of cancer of the cervix among American Indians is 19.5/100,000 versus 7.8/100,000 in U.S, whites, and comparison by geographic region/tribe indicates that the r ate is four to six times higher in some tribes. Papanicolaou cytological te sting (Pap smear) permits the detection of cervical lesions before they bec ome cancerous, effectively reducing the incidence of cervical cancer by 75- 90%. The American Cancer Society recommends a Pap smear every year beginnin g at age 18 years or when sexually active, and more frequent screening in h ighrisk populations. Methods. A random household cross-sectional survey was conducted in Phoenix , Arizona, to assess cervical cancer screening rates among 519 adult urban American Indian women. Logistic regression was used to identify predictors of Pap smear use. Results. Three-quarters (76.1%) of urban women American Indian surveyed rec eived a Pap smear within the past 3 years, but only 49.5% received a Pap sm ear within the last year. Women over age 50 years were significantly less l ikely to have received a recent Pap smear in comparison to younger women, Conclusions. The results of this study indicate that limited access to heal th care and lack of knowledge about the procedure were important barriers t o Pap smear use. Improving cervix cancer screening participation rates is a n important step in reducing the disease burden in this high-risk populatio n, (C) 1999 American Health Foundation and Academic Press.