Effects of social support, regular physician and health-related attitudes on cervical cancer screening in an Asian population

Objective: Out primary objective was to examine sociodemographic and attitu dinal factors that affect uptake of the Pap smear in a multi-ethnic Asian p opulation. Methods: We conducted a prevalence survey among women aged 50-64 years livi ng in Singapore and ascertained by means of an in-person questionnaire inte rview their Pap screening history, demographic characteristics, informal so cial support and attitudes towards early detection. Results: We found that, after adjusting for demographic variables known to be predictors of Pap screening, women who reported ever having a Pap smear were more likely to have close friends with whom they could discuss health (adjusted odds ratio (OR) 2.1, 95% confidence intervals (CI) 1.2-3.6), and have a regular physician (adjusted OR 2.3 (1.3-4.1)). Based on responses to four indices measuring health attitudes, they were significantly less like ly to express a fatalistic viewpoint towards health and illness (adjusted O R for highest vs. lowest tertile 0.3 (95% CI 0.1-0.7)), and more likely to believe that early detection could improve the outcome (adjusted OR 3.3 (95 % CI 1.4-7.8)). The nature of the test itself was a significant barrier to having a Pap smear, but only among women with fewer years of education. Conclusions: Our results suggest that, within this Asian population, a mult i-pronged approach is required to reach unscreened women. The role of physi cians and close friends should be emphasized, and health messages should be formulated to address specific, relevant attitudinal barriers to Pap scree ning.